Minimum Five-Year Outcomes of Hip Arthroscopy in Patients with Obesity: A Matched-Pair Analysis

Purpose: To compare patients with obesity that underwent hip arthroscopy for femoro-acetabular impingement (FAI) and labral tears to a match-controlled group of non-obese patients.

Methods: Data were prospectively collected and retrospectively reviewed for patients that underwent arthroscopy between 2/2008 and 12/2011. Inclusion criteria were treatment for FAI and labral tears, and completed preoperative patient-reported outcomes (PROs) and visual analogue scale (VAS). Exclusion criteria were previous ipsilateral hip conditions or preoperative Tönnis grade ≥2. Patients with obesity (BMIs ≥30) were matched 1:1 to non-obese patients (BMIs 18.5-24.99) based on age at surgery ±5 years, sex, acetabular Outerbridge grade (0, 1 vs. 2-4), and capsular treatment.

Results: Of 96 obesity cases with follow-up, 74 were pair-matched to control cases. Mean BMIs were 34.3 and 22.7 for the obesity and control groups respectively (p<0.0001). Mean follow-up time was 71.6 months and 71.3 months for the obesity and control groups respectively (p=0.41). All mean preoperative PROs and VAS were significantly worse in the obesity group. No differences were observed regarding demographics, intraoperative findings, procedures, follow-up scores, magnitudes of improvement, or secondary arthroscopy rates. Both groups demonstrated significant improvements in mean outcomes scores at ≥5-years. In both groups, no significant differences were detected in mean outcomes scores between 2 years and ≥5-years. Conversion rates to total hip arthroplasty (THA) were 29.7% and 14.9% for the obesity and control groups respectively (relative risk=2.0; 95% CI 1.1 to 3.8; p=0.04).

Conclusion: Hip arthroscopy for the treatment of FAI and labral tears in patients with obesity yielded significant improvements at ≥5-years, which were similar to a matched group of non-obese patients. However, patients with obesity demonstrated a two-fold increased risk for conversion to THA.