Does the Degree of Obesity Affect Mid-Term Outcomes after Hip Arthroscopy for the Treatment of Femoro-Acetabular Impingement and labral tears?

Background: Obesity has been previously identified as a negative prognostic factor for surgery in general and for hip arthroscopy in particular.

Purpose: To evaluate the minimum five-year outcomes of hip arthroscopy for the treatment of femoro-acetabular impingement (FAI) and labral tears in three groups stratified by BMI: <30, 30 to 34.9, and 35 to 39.9.

Methods: Data were prospectively collected for patients that underwent hip arthroscopy between February 2008 and April 2011. Inclusion criteria were as follows: underwent arthroscopy to treat FAI and labral tears, and preoperative modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score – Sports Specific Subscale (HOS-SSS), and visual analog scale (VAS). Exclusion criteria were previous hip conditions, previous ipsilateral hip surgery, or preoperative Tönnis osteoarthritis grade ≥2. Three groups were compared: BMI

Results: Of 451 eligible cases, 379 had minimum five-year follow-up (84.0%). Mean preoperative mHHS (p = 0.006), NAHS (p = 0.005), HOS-SSS (p = 0.021), and VAS (p = 0.01) were significantly inferior in the obese class I and class II groups relative to the control. Improvements were observed for all outcomes at latest follow-up in each group (p < 0.0001). Mean patient satisfaction for the control, obese class I, and obese class II groups was 8.0, 7.9, and 7.6, respectively. A trend towards inferior outcomes was observed based on increasing degree of obesity. The obese class I and class II groups demonstrated higher rates of conversion to THA relative to the control group (p = 0.006).

Conclusion: Hip arthroscopy for the treatment of FAI and labral tears demonstrates significantly improved outcomes at minimum five-year follow-up for BMIs