Background:We aimed to understand the adult experience of hip pain through a web-based REDCap platform via social media. The purpose of this study was to assess the possibility of collecting patient-reported data through social media in people with hip pain while outlining the contents of the survey and analyzing the demographics of the sample population. Methods:The survey link was active from October 1, 2023, to May 1, 2024, and available on social media platforms. Respondents provided consent prior to survey participation. Responses were anonymous, and only unique, fully complete surveys were analyzed. The comprehensive hip survey included demographic and overall health reporting, as well as hip-specific diagnoses, hip-specific functional measures, and mental health outcomes. Results:Six hundred twenty-seven surveys were initiated, with 509 surveys completed. Twenty-six countries were represented with most responses originating from the United States (72.1%, n = 367), United Kingdom (10%, n = 51), Canada (5.5%, n = 28), and Australia (4.1%, n = 21). Ninety-three percent of respondents were women, with a mean age of 39 (range: 18-77). Top diagnoses reported were hip dysplasia (60.9%, n = 310), femoroacetabular impingement syndrome (45.2%, n = 230), Perthes disease (6.4%, n = 33), and osteoarthritis (6.3%, n = 32). Seventy-one percent (n = 366) reported previous hip surgery, with hip arthroscopy (60.7%, n = 222), periacetabular osteotomy (50.3%, n = 184), and total hip arthroplasty (24.3%, n = 89) being the most reported procedures. Conclusions:This study demonstrates the feasibility of utilizing social media for a comprehensive web-based survey to gather patient-reported outcomes from individuals with various sources of hip pain internationally.

Background: Greater trochanteric pain syndrome (GTPS) is a commonly diagnosed medical issue, yet there are little data assessing the relative morbidity of GTPS. We sought to characterize the morbidity on presentation of GTPS and compare it to that of patients with end-stage hip osteoarthritis awaiting total hip arthroplasty. We hypothesized that patients with GTPS would have morbidity similar to or worse than that of patients with osteoarthritis. Materials and Methods: This retrospective case-control study examined patient-reported outcome measures of 156 patients with GTPS (193 hips) and 300 patients with hip osteoarthritis before total hip arthroplasty (326 hips). Patients with secondary hip conditions or previous hip surgeries were excluded from the study. Patient-reported outcome measures were analyzed using an equivalence test and two one-sided t tests. Results: Equivalence in mean visual analog scale pain scores between GTPS and osteoarthritis was established with a tolerance margin of ±10. The difference in mean visual analog scale pain scores was 0.35 (95% CI, −0.86 to 0.16; P =.02). The Hip disability and Osteoarthritis Outcome Score Quality of Life was much worse for patients with GTPS, placed well outside of the ±10 tolerance margin, and the difference in mean scores was 1.72 (95% Cl, −2.17 to −1.26; P =.99). Equivalence in mean UCLA Activity scores between GTPS and osteoarthritis was established with a tolerance margin of ±5. The difference in mean UCLA Activity scores was 0.002 (95% CI, −0.45 to 0.43; P <.01). Conclusion: The morbidity and functional limitations of patients with GTPS were similar to those of patients undergoing total hip arthroplasty. GTPS remains a functional problem for patients, and clinicians and researchers should consider GTPS as seriously as hip osteoarthritis. [ Orthopedics . 2024;47(4):205–210.]

Background The Bernese Periacetabular Osteotomy (PAO) has become a popular surgery for fixing development dysplasia of the hip, yet the most common concerns of the PAO population remains ambiguous. The aim of this study was to investigate Facebook, Instagram and Twitter to further understand what the most common preoperative and postoperative questions patients undergoing PAO are asking. We hypothesized most questions would be asked by patients in the preoperative timeframe with regards to education surrounding PAO surgery. Methods Facebook, Instagram and Twitter were queried consecutively from February 1, 2023 to November 23, 2011. Facebook was searched for the two most populated interest groups; “Periacetabular Osteotomy (PAO)” and “Periacetabular Osteotomy Australia”. Instagram and Twitter were queried for the most popular hashtags: “#PAOwarrior”, “#PAOsurgery”, “#periacetabularosteotomy”, “#periacetabularosteotomyrecovery”, and “#paorecovery”. Patient questions were categorized according to preoperative and postoperative questions. Questions were further placed into specific themes in their respective preoperative or postoperative question types. Results Two thousand five hundred and fifty-nine posts were collected, with 849 (33%) posts containing 966 questions. Of the 966 questions, 443 (45.9%) and 523 (54.1%) were preoperative and postoperative questions, respectively. The majority of questions were postoperative complication related (23%) and symptom management (21%). Other postoperative questions included recovery/rehabilitation (21%), and general postoperative questions (18%). The most common preoperative questions were related to PAO education (23%). Rehabilitation (19%), hip dysplasia education (17%), and surgeon selection (12%) were other preoperative questions topics included. Most questions came from Facebook posts. Of 1,054 Facebook posts, 76% were either preoperative or postoperative questions and from the perspective of the patient (87%). Conclusion The majority of patients in the PAO population sought advice on postoperative complications and symptom management. Some patients asked about education surrounding PAO surgery. Understanding the most common concerns and questions patients have can help providers educate patients and focus on more patient-relevant perioperative conversations.

Introduction Diabetes mellitus (DM) encompasses metabolic disorders characterized by elevated blood sugar. This study aimed to evaluate the prevalence and associated metrics of DM in the Rio Grande Valley (RGV), a low-income and medically underserved region in the United States, and compare these metrics to the national averages from 2012 to 2022. Methods  A retrospective cross-sectional analysis was conducted using publicly accessible data from the Centers for Medicare and Medicaid Services (CMS). Metrics analyzed included DM prevalence, average principal cost, rates of emergency department visits, hospitalizations, screenings, and prevalence of obesity. Data from the RGV counties were compared to national averages using Mann-Whitney U tests, with a p-value of <0.05 considered significant. Results From 2012 to 2022, DM affected patients in the RGV (43.95%) at significantly higher rates than the national average (26.73%) (p < 0.001). Obesity prevalence in the RGV was at higher rates than the national average (24.41% vs. 15.55%, p < 0.01). The screening rates of DM exceeded the national average (10.64% vs. 5.09%, p < 0.001). The average principal cost for patients in the RGV ($1,920.45) to treat DM was significantly greater than the national average principal cost ($859.64) (p < 0.001). The RGV also reported higher rates of ED visits (16.82 vs. 8.82 per 1,000 beneficiaries, p < 0.001) and hospitalizations (7.75 vs. 3.82 per 1,000 beneficiaries, p < 0.001). Conclusion The RGV exhibits significantly higher rates of DM and DM-associated metrics compared to the national averages, highlighting substantial public health disparities.

Background Social media is a popular resource for patients seeking medical information and sharing experiences. Periacetabular osteotomy (PAO) is an accepted treatment for symptomatic acetabular dysplasia with a low published complication profile in specialty centers. Little is known regarding patient reporting of complications on social media following PAO. The purpose of this study was to describe the patient-perceived complications of PAO posted on social media and analyze how additional factors (postoperative timeframe, concomitant surgery) correlate with these complication posts. Methods Facebook and Instagram were queried from 02/01/18–02/01/23; Twitter was searched over an extended range back to 02/01/11. Facebook posts (1054) were collected from the two most populated interest groups; “Periacetabular Osteotomy” and “PAO Australia.” Instagram posts (1003) and Tweets (502) were found using the same five most popular hashtags: #PAOwarrior, #periacetabularosteotomy, #periacetabularosteotomysurgery, #PAOsurgery, and #PAOrecovery. Posts were assessed for demographic data, perspective, timing (early postoperative or late postoperative), additional surgeries, type of complication, and post engagement. Results Facebook posts (1054), Instagram posts (1003), and Tweets (502) were assessed; 13.6% of posts included a complication. The majority of complications were reported > 6 months postoperatively with excessive pain being the most common complication (57.2%), including chronic pain (41.8%), acute pain (6.7%), and nerve pain (8.8%). Bony complications (6.7%), neurologic/psychiatric complications (3.8%), swelling (1.7%), infection (1.4%), other specified complications (16.2%), and unspecified complications (10.2%) were reported. Complication posts were found to be correlated with postoperative timeframe and concomitant surgery. Post engagement decreased in complication-related posts. Conclusions Few patients posted a perceived complication associated with PAO surgery. Of those who did, the majority reported unmanageable pain during the late postoperative period. Posts including a perceived complication were found to be positively correlated with postoperative timeframe and negatively correlated with concomitant surgery. This study found a higher pain complication rate, but a lower overall complication rate compared to prior studies. Considering the social media reported complications of PAO patients in addition to traditional outcome measures reveals which aspects of postoperative recovery are most important to patients themselves.

Introduction Osteoarthritis and rheumatoid arthritis, two of the most common forms of arthritis worldwide, are chronic diseases affecting the joints. The Rio Grande Valley is characterized by an abundance of health disparities, with previous studies showing increased rates of multiple diseases and disorders in this region. This study aimed to determine both the prevalence and the risk-adjusted average cost of osteoarthritis and rheumatoid arthritis in the Rio Grande Valley and to compare them with the national average. We hypothesize that the prevalence and risk-adjusted average cost of osteoarthritis and rheumatoid arthritis in the Rio Grande Valley will be greater than the corresponding national averages.  Methods Publicly accessible Medicare beneficiary data were utilized for our retrospective longitudinal, observational study. Osteoarthritis and rheumatoid arthritis data for risk-adjusted average total cost, overall prevalence, sex-stratified prevalence, and ethnicity-stratified prevalence, from 2012 to 2022, were compared between the Rio Grande Valley and the national means using specific domains of the "Mapping Medicare Disparities by Population" tool. Independent t-tests and a Mann-Whitney U test compared prevalence rates and risk-adjusted average total cost means, respectively, between the Rio Grande Valley and the national averages.  Results Overall, the prevalence of osteoarthritis and rheumatoid arthritis in the Rio Grande Valley was significantly higher than the national average (39.9% vs. 26.9%, p < 0.001). Women in the region exhibited significantly higher rates of osteoarthritis and rheumatoid arthritis compared to the national average (47.6% vs. 32.1%, p < 0.001), and a similar trend was seen among Hispanic residents (41.6%) compared to the national mean (32.1%) (p < 0.001). Furthermore, the risk-adjusted average total cost for individuals residing in the Rio Grande Valley ($16,084.40) significantly exceeded the risk-adjusted average total cost nationally ($13,073.90) (p < 0.001). Conclusion In the Rio Grande Valley, there is an increased prevalence of osteoarthritis and rheumatoid arthritis compared to the national mean of Medicare beneficiary patients, particularly in women and those of Hispanic heritage. The substantial increase in risk-adjusted average total cost to treat osteoarthritis and rheumatoid arthritis highlights the economic burden faced by residents in the region.

Background Chronic hip pain is a debilitating condition that severely reduces one's quality of life. Prior studies uncovered a link between hip pathologies and pain catastrophizing, anxiety, and depression. The purpose of this study was to investigate whether hip preservation surgery in patients with femoroacetabular impingement syndrome (FAIS) and acetabular dysplasia (AD) improves functional outcomes and pain catastrophizing. Methods Patients with FAIS and AD were requested to complete a hip questionnaire both preoperatively and postoperatively at a single academic center (University of Texas Southwestern Medical Center, Dallas, Texas, USA). Pain catastrophizing was evaluated using the pain catastrophizing scale, and pain level was assessed using the visual analog scale. Assessments of hip functional outcomes included the hip outcome score (HOS) and the hip disability and osteoarthritis outcome score (HOOS). Outcome measures before and after treatment were compared using the dependent samples t-test. A correlation analysis, using the Spearman partial correlation coefficient (rs), was conducted to evaluate the relationship between variables. Results The results indicated a clinically significant improvement in functional measures and pain catastrophizing in patients who underwent hip preservation surgery. The most significant discovery was an inverse relationship between both HOOS quality of life (rs=-0.293, p=0.0065, false discovery rate (FDR)=0.0210) and HOS activities of daily living (rs=-0.242, p=0.0254, FDR=0.0423) and pain catastrophizing; however, similar improvements were seen in pain catastrophizing with improvements in other functional outcomes. Conclusion Undergoing hip preservation surgery for patients with AD or FAIS improved their hip functional measures and decreased pain catastrophizing postoperatively. The improvement of hip function, quality of life, and pain catastrophizing reveals an intricate link between the functional outcomes of hip preservation surgery and pain catastrophizing.

Abstract Background As total hip arthroplasty (THA) indications continue to expand and longevity increases, it is important to understand the outcomes in different patient populations. Younger, more active patients are electing to proceed with THA with differing severity of disease. We aimed to investigate patient reported outcome measures (PROMs) in patients who underwent THA with less severe radiographic hip arthrosis.Methods Pre- and post-operative PROMs and radiographic data (joint-space width, Tonnis grade) for patients undergoing THA between 9/16/2016 and 10/21/2021 by a single surgeon were collected. Baseline Tonnis grades were stratified, and PROMs, including Harris Hip Score (HHS), Hip Outcome Score (HOS), and Short-Form-12 Scale (SF-12), were compared pre- and post-operatively.Results Four-hundred and sixty-two hips underwent analysis. Pre-operative HHS following THA were ​​46.6 ± 11.9, 47.5 ± 11.4, 44.4 ± 9.6, and 42.1 ± 10.7 for Tonnis grades 0 (n = 27), 1 (n = 56), 2 (n = 73), and 3 (n = 306), respectively; while post-operative HHS were 86.4 ± 7.8, 88.4 ± 7.7, 89.5 ± 4.4, and 88.7 ± 5.4 Higher postoperative HOS scores were seen in Tonnis grade 0 and 1, when compared to Tonnis grades 2, and 3 (49.1 ± 27.9, and 50.1 ± 20.8 vs. 47.0 ± 22.2, and 44.0 ± 22.2, respectively; p = 0.003), however, no statistical difference was seen in mean difference HOS (p = 0.447). For SF-12, the mean improvement in order of increasing Tonnis grades was 16.7 ± 48.7, 9.2 ± 38.3, 6.6 ± 43.4, and 14.9 ± 45.2 with no statistical significance observed (p = 0.565).Conclusion In patients undergoing THA, post-operative HHS scores are similar regardless of baseline radiographic severity. Post-operative change in HOS and SF-12 scales was consistently higher across all baseline Tonnis grades prior to THA, while mean change remained comparable. These findings suggest although preoperative radiographic data aids in the evaluation of patients with hip pain, the severity of findings should not determine surgical candidacy. This study challenges radiographic severity for THA eligibility and adds to THA literature for those with less severe radiographic findings.

Aims: Social media is a popular resource for patients seeking medical information and sharing experiences. periacetabular osteotomy (PAO) is the gold-standard treatment for symptomatic acetabular dysplasia with good long-term outcomes. However, little is known regarding the perceived outcomes of PAO on social media. The aims of this study were to describe the perceived outcomes following PAO using three social media platforms: Facebook, Instagram, and X (formerly known as Twitter). Methods: Facebook, Instagram, and X posts were retrospectively collected from 1 February 2023. Facebook posts were collected from the two most populated interest groups: “periacetabular osteotomy” and “PAO Australia.” Instagram and X posts were queried using the most popular hashtags: #PAOwarrior, #periacetabularosteotomy, #periacetabularosteotomyrecovery, #PAOsurgery, and #PAOrecovery. Posts were assessed for demographic data (sex, race, location), perspective (patient, physician, professional organization, industry), timing (preoperative vs postoperative), and perceived outcome (positive, negative, neutral). Results: A total of 1,054 Facebook posts, 1,003 Instagram posts, and 502 X posts were consecutively assessed from 887 unique authors. The majority (63.3%) of these posts were from patients in the postoperative period, with a median of 84 days postoperatively (interquartile range 20 to 275). The longest follow-up timeframe postoperatively was 20 years. Regarding perceived outcomes, 52.8% expressed satisfaction, 39.7% held neutral opinions, and 7.5% were dissatisfied. Most dissatisfied patients (50.9%) reported pain (chronic or uncontrolled acute) as an attributing factor. Conclusion: Most PAO-perceived surgical outcomes on social media had a positive tone. Findings also indicate that a small percentage of patients reported negative perceived outcomes. However, dissatisfaction with PAO primarily stemmed from postoperative pain. Social media posts from other sources (physicians, hospitals, professional organizations, etc.) trend towards neutrality. Healthcare providers must consider the social media narratives of patients following PAO, as they may reveal additional outcome expectations and help improve patient-centred care, create informed decision-making, and optimize treatment outcomes. Cite this article: Bone Jt Open 2024;5(1):53–59.

Introduction: Osteoporosis is characterized by decreased bone mass and decreased bone quality, leading to increased bone fragility and risk of fractures. The number of fractures due to osteoporosis is projected to increase to over three million by the year 2025 and cost $25.3 billion annually. It ranks highly among diseases that cause patients to become bedridden with serious complications and reduced quality of life. Additionally, osteoporosis disproportionately affects Hispanics, which comprise most of the Rio Grande Valley (RGV) population. Therefore, our primary objective was to determine the prevalence of osteoporosis within the RGV. Additionally, we had secondary objectives to determine the screening rates of osteoporosis in the RGV and identify other potential risk factors associated with osteoporosis. We hypothesize that individuals residing in the RGV have higher rates of osteoporosis and lower rates of osteoporosis screening than the national average. Methods: This retrospective observational cross-sectional study utilized Medicare beneficiary data via the "Mapping Medicare Disparities by Population" interactive tool. Osteoporosis data were compared within the RGV (comprising Starr, Hidalgo, Cameron, and Willacy counties) and compared with national averages between the years 2016 and 2021. Statistical analysis included prevalence ratios with 95% confidence intervals and chi-square values when applicable. Results: Among Medicare beneficiaries residing in the RGV, there are higher rates of osteoporosis compared to the national average (11.5% vs. 7.20%; p < .00001). Screening for osteoporosis within the RGV is above the national average (9.29% vs. 6.67%, p < .00001). Hispanics residing in the RGV have higher overall rates of osteoporosis than Caucasians residing in the RGV (12.3% vs. 8.60%, p < .00001). Females residing in the RGV have nearly twice the rate of osteoporosis compared to the national average (19.1% vs. 11.8%, p < .00001) and 6.58 times the rate of males residing in the RGV (19.1% vs. 2.9%, p < .00001). Conclusion: Individuals residing in the RGV are disproportionately affected by osteoporosis. Despite increased screening rates seen among Medicare beneficiaries, we also suspect many individuals, uninsured or undocumented, have not received any appropriate osteoporosis screening. Risk factors in the RGV associated with higher rates of osteoporosis could include low education levels, socioeconomic status, physical activity, and mineral intake. These results demonstrate a need to address osteoporosis health literacy, promote earlier interventions to treat osteoporosis and increase healthcare accessibility in the RGV.