Abstract
Purpose: Prior studies demonstrate hip arthroscopy is effective at improving patient-reported outcomes (PROs) after hip arthroscopy for femoracetabular impingement syndrome (FAIS) in both overweight and obese patients at 5-year follow-up, but to a lesser degree than patients with normal body mass index (BMI). The purpose of this investigation was to evaluate PROs at 10-year follow-up.
Methods: We conducted a retrospective review of 154 patients undergoing hip arthroscopy for FAIS at a single institution from 2010 to 2013 with minimum 10-year follow-up. Patients were evaluated at baseline, 1-month, 3-months, 6 months, 1-year, 2-years, 5-years, and 10-years, using the Modified Harris Hip Score (MHHS) and Nonarthritic Hip Score (NAHS). Individuals were stratified into 4 cohorts based on their BMI: underweight (BMI <18.5 kg/m2), normal weight (BMI 18.5 to 24.9 kg/m2), overweight (BMI 25.0 to 29.9 kg/m2), and obese (BMI ≥30.0 kg/m2). Preoperative to postoperative improvement was assessed using paired t-tests. Absolute postoperative scores were assessed between BMI groups using an ANOVA that controlled for age and sex.
Results: A total of 154 patients (64.9% female) with a mean age of 40.0 ± 13.0 years (15.0-75.9) and average follow up of 11.9 ± 1.1 years (10.0-13.9) were included in this analysis. The patients had an average BMI of 24.7 ± 4.1 kg/m2 (range 17.9-36.9) and were stratified into 4 cohorts: underweight (n=4), normal (n=88), overweight (n=41), obese (n=21). Eight (4.7%) patients underwent revision surgery and 10 (5.8%) converted to total hip arthroplasty (THA). The normal, overweight, and obese groups showed significant improvement in MHHS and NAHS at 10 years compared to baseline (p<0.02), which was sustained from all intermediate time points (p<0.001). Despite preoperative to postoperative improvement, patients in the obese group had significantly lower postoperative MHHS and NAHS scores than the normal (p<0.001) and overweight group (p<0.02) at 10-year follow-up.
Conclusion: At 10-year follow-up, patients continue to experience significantly improved PROs after hip arthroscopy, regardless of BMI. However, obese patients have inferior postoperative PROs than normal or overweight patients.