Factors Associated with High Pain Catastrophizing in Patients Undergoing Hip Arthroscopy for Femoroacetabular Impingement Syndrome

Purpose: The purpose of this study was to determine if physical health, mental health, and patient specific factors are associated with increased Pain Catastrophizing in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS). 
Methods: Patients who underwent primary hip arthroscopy for FAIS were retrospectively analyzed. Patients were included if they completed a standard preoperative questionnaire which included the PCS, VAS, and SF-12 physical and mental composite scores. Patient specific variables including age, gender, BMI, tobacco use, number of allergies, preoperative opioid use and diagnosis of depression or anxiety were recorded. Multiple linear regression was performed to assess for a relationship between physical and mental health scores, patient specific variables, and a “High Catastrophizing” PCS score. 
Results: 168 patients were included in this study. Patients with a PCS score of 22 or above were categorized as “High Catastrophizing.” The variables included in the multiple linear regression model statistically significantly predicted high pain catastrophizing, F (10,149) = 4.75, p<0.001, R2=0.4. SF12 Physical and Mental Composite Scores and a mental health illness diagnosis added statistically significantly to the prediction, p<0.005. 
Conclusion: Preoperative hip arthroscopy patients with better general physical and mental health, as measured by the SF-12, and those without mental health illness are less likely to having higher pain catastrophizing scores. Age, gender, BMI, VAS, tobacco use, number of allergies, and preoperative opioid use were not independently associated with elevated pain catastrophizing scores. These findings may be helpful when interpreting PCS scores and counseling patients prior to arthroscopic hip surgery.