Preoperative Temporal Summation is Associated with Impaired Recovery Following Hip Arthroscopy for Femoroacetabular Impingement Syndrome

Overview

Journal Arch Bone Jt Surg

Date 2024 Aug 30

PMID 39211569

Authors

Kate N Jochimsen

Emilie Kramer

Joshua Van Wyngaarden

Brian Noehren

Michael A Samaan

Stephen T Duncan

Carl G Mattacola

Cale A Jacobs

Affiliations

Soon will be listed here.

Abstract

Objectives: Chronic pain is a risk factor for worse outcomes following hip arthroscopy for femoroacetabular impingement syndrome (FAIS). Pain sensitization involves the central nervous system perceiving previously innocuous stimuli as noxious. Temporal summation can provide a surrogate measure of sensitization, and may be a clinical tool to identify patients at a higher risk for poor post-hip arthroscopy outcomes. Therefore, we aimed to 1) identify the prevalence of temporal summation in patients undergoing hip arthroscopy for FAIS, 2) determine if there a difference in postoperative improvement between individuals with and without preoperative temporal summation, and 3) examine preoperative predictors of poor postoperative recovery.

Methods: 51 participants undergoing hip arthroscopy for FAIS underwent preoperative temporal summation testing. Three months postoperatively, 38 participants completed the 12-item International Hip Outcome Tool (iHOT-12) and reported their overall symptomatic improvement (0% to 100%, with 100% being normal). Participants were categorized on the presence ( Numeric Pain Rating Scale; NPRS 2) or absence ( NPRS < 2) of temporal summation. A Mann-Whitney U test was used to determine the difference in improvement between groups (temporal summation: temporal summation (TS), no temporal summation (NTS), and a linear regression was used to explore predictors of improvement.

Results: 23 (45.1%) of 51 participants displayed preoperative temporal summation. In participants with postoperative data, those with temporal summation reported less improvement than those without (TS: 62.8% 29.7%; NTS: 82.7% 13.9%; p = 0.01; Cohen's d = -0.86). Temporal summation (Beta = -0.48; 95% CI -36.6, -8.7) and mental health disorder (Beta = -0.30; 95% CI -28.0, -0.48) predicted 28.1% of the variance in postoperative improvement (p = 0.002).

Conclusion: The presence of preoperative temporal summation is common and related to worse postoperative recovery after hip arthroscopy for FAIS.

Citing Articles

Outcomes and Complications of Arthroscopic Treatment for Septic Arthritis of the Hip: A Systematic Review.

Poursalehian M, Hajiaghajani S, Sabaghian A, Hoveidaei A, Conway J Arch Bone Jt Surg. 2025; 13(2):62-74.

PMID: 39980797 PMC: 11836794. DOI: 10.22038/ABJS.2024.80263.3668.

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