Correlation of obesity with patient-reported outcomes and complications after hip arthroscopy

Abstract

Purpose: This study aimed to evaluate patient-reported outcomes and complications after hip arthroscopy in an obese population compared with a matched nonobese control group with a minimum 2-year follow-up, using the Modified Harris Hip Score (MHHS) and Nonarthritic Hip Score (NAHS).

Methods: Data were analyzed from 21 consecutive obese patients (body mass index [BMI] ≥ 30) and 18 nonobese patients (BMI < 25) who underwent hip arthroscopy between 2009 and 2012 with a minimum follow-up of 2 years. Data collected included MHHS, NAHS, traction and intraoperative times, and postoperative complications.

Results: Traction times were similar between obese and nonobese patients at 48 and 45 minutes (P = .51), respectively. Operative times were also similar at 54 and 51 minutes (P = .79), respectively. Each group had a statistically significant improvement in MHHS from baseline to final follow-up: 45 to 79 (P < .001) in the obese group and 49 to 81 (P < .001) in the nonobese cohort. Similarly, the NAHS showed significant improvement in each group from baseline to final follow-up: 43 to 75 (P < .001) in the obese cohort and 45 to 83 (P < .001) in the nonobese group. There was no difference between groups in MHHS or NAHS data. There were 8 complications in the obese group, most commonly deep vein thrombosis (DVT) and worsened pain, whereas the nonobese cohort had one complication (an instance of heterotopic ossification [HO]). Overall, obese patients had 11.1 times the risk of a complication developing than did nonobese patients (95% confidence interval, 1.2 to 99.7).

Conclusions: Hip arthroscopy in the obese patient population leads to improved short- to mid-term patient-reported outcomes similar to those seen in nonobese patients. Obese patients, however, are at a significantly increased risk of postoperative complications such as DVTs and worsened hip pain.

Level of evidence: Level IV, therapeutic case series.