Preoperative Expectations Do Not Correlate With Postoperative iHOT-33 Scores and Patient Satisfaction Following Hip Arthroscopy for the Treatment of Femoroacetabular Impingement Syndrome.

PURPOSE: To examine the correlation between preoperative patient expectation and International Hip Outcome Tool (iHOT-33) score and postoperative satisfaction of patients undergoing hip arthroscopy for the treatment of femoroacetabular impingement syndrome. METHODS: Patients scheduled for surgery completed the Hip Preservation Surgery Expectations Survey (HPSES), as well as the preoperative and a minimum 2-year postoperative iHOT-33. Patient demographics that were collected included gender, age, occupation, and body mass index (BMI). At the latest follow-up, patients were evaluated for their subjective satisfaction and postoperative complications. An in-depth analysis was performed to assess the correlation between HPSES, iHOT-33, and patient satisfaction. RESULTS: Sixty-nine patients (62.3% males; mean age: 33.7 ± 13.1 years; BMI: 23.9 ± 3.5 kg/m2) were included in this study. The mean HPSES score was 83.8 ± 16.5. The mean iHOT-33 improved from 31.6 ± 15.8 preoperatively to 73 ± 25.9 postoperatively (95% CI = 35.2,47.8; P < .01), and the mean patient satisfaction was 75.9 ± 26.9. There were no statistically significant differences in mean HPSES score between males and females (95% CI = 79.9,87.8; P = .35) nor between different occupational groups (95% CI = 79.4,87.6, P = .095). No correlation was found between age and HPSES score (r = .036; P =.76). There was a negligible correlation between HPSES score and postoperative iHOT-33 score (r = -.117; P = .34) and patient satisfaction (r = -.042; P = .73). Postoperative iHOT-33 score had a significant high correlation with patient satisfaction (r = .8; P < .001). CONCLUSION: Preoperative expectations do not correlate with postoperative iHOT-33 scores and patient satisfaction with surgery at 2 years after surgery. Gender and occupation did not differ significantly with regard to preoperative expectations, and there was no correlation between age and HPSES score. LEVEL OF EVIDENCE: IV, retrospective case series.

The Grafting of Multifunctional Antithrombogenic Chemical Networks on Polyurethane Intravascular Catheters.

Intravascular catheters (IVCs) and other medical tubing are commonly made of polymeric materials such as polyurethane (PU). Polymers tend to be fouled by surface absorption of proteins and platelets, often resulting in the development of bacterial infections and thrombosis during catheterization, which can lead to embolism and death. Existing solutions to fouling are based on coating the IVCs with hydrophilic, anti-thrombogenic, or antimicrobial materials. However, the delamination of the coatings themselves is associated with significant morbidity, as reported by the United States Food and Drug Administration (FDA). We developed a lubricious, antimicrobial, and antithrombogenic coating complex, which can be covalently attached to the surface of industrial PU catheters. The coating complex is pre-synthesized and comprises 2-methacryloyloxyethyl phosphorylcholine (MPC) as an antifouling agent, covalently attached to branched polyethyleneimine (bPEI) as a lubricating agent. The two-step coating procedure involves PU-amine surface activation using a diisocyanate, followed by chemical grafting of the bPEI-S-MPC complex. Compared with neat PU, the coating was found to reduce the coefficient of friction of the IVC surface by 30% and the hemolysis ratio by more than 50%. Moreover, the coating exhibited a significant antimicrobial activity under JIS Z2801:2000 standard compared with neat PU. Finally, in in-vivo acute rabbit model studies, the coating exhibited significant antithrombogenic properties, reducing the thrombogenic potential to a score of 1.3 on coated surfaces compared with 3.3 on uncoated surfaces. The materials and process developed could confer lubricious, antithrombogenic, and antimicrobial properties on pre-existing PU-based catheters.