2025 ISAKOS Biennial Congress Paper
10-Year Outcomes Of Hip Arthroscopy For Femoroacetabular Impingement In Obese Patients
Roger Quesada Jimenez, MD, Des Plaines, Illinois UNITED STATES
Tyler R. McCarroll, MD, Des Plaines, IL UNITED STATES
Andrew R. Schab, BS, Des Plaines, Illinois UNITED STATES
Ady Haim Kahana Rojkind, MD, Des Plaines, IL UNITED STATES
Drashti Sikligar, MEng, Des Plaines, IL UNITED STATES
Benjamin G. Domb, MD, Des Plaines, Illinois UNITED STATES
American Hip Institute Research Foundation, Des Plaines, Illinois, UNITED STATES
FDA Status Cleared
Summary
Hip arthroscopy in obese patients yielded significant long-term improvements, but patients with obesity had more than 2-fold odds of conversion to arthroplasty than normal weight patients.
Abstract
Purpose
To conduct a propensity matched long-term analysis of patients with obesity who underwent hip arthroscopy for femoroacetabular impingement (FAI) and labral tears.
Methods
Prospectively collected data was retrospectively analyzed for patients who underwent hip arthroscopy as treatment for FAI and labral tears between 2008 and 2013 with a body mass index (BMI) ≥ 30 kg/m2. Included patients had completed pre- and postoperative patient reported outcomes (PROs) at minimum 10-year follow-up. Patients were propensity matched to a control group of normal weight patients (BMI 20-24.99 kg/m2) in a 1:1 ratio by sex, age at surgery, Acetabular Outerbridge Grade, and capsular treatment. PROs, clinically meaningful thresholds, and survivorship were compared. A subanalysis based on BMI subgroups was completed.
Results
A total of 266 patients were included in the study with an average follow-time of 125.19 ± 43.07 months. Obese patients had significantly lower preoperative scores for all PROs compared to the control group. However, at 10-year minimum follow-up, postoperative scores for NAHS, HOS-SSS, and VAS of the obese group were comparable to those of the control group. Both groups achieved MCID and PASS for mHHS, NAHS, and HOS-SSS at similar rates (p < 0.05). Obese patients had a higher frequency of conversion to arthroplasty with an odds ratio of 2.19 (95% CI [1.17 - 4.13], p < 0.05). Morbidly obese patients (BMI ≥ 40 kg/m2) reached MCID and PASS for mHHS at significantly lower rates.
Conclusions
Hip arthroscopy in obese patients yielded significant long-term improvements. However, patients with obesity had more than 2-fold odds of conversion to arthroplasty than normal weight patients. Morbidly obese patients did not experience significant improvements in functional PROs and achieved clinical thresholds at lower rates and should therefore be approached with caution.