PMID- 29870448
OWN - NLM
STAT- MEDLINE
DCOM- 20190909
LR  - 20190909
IS  - 1535-1386 (Electronic)
IS  - 0021-9355 (Linking)
VI  - 100
IP  - 11
DP  - 2018 Jun 6
TI  - Minimum Five-Year Outcomes of Hip Arthroscopy for the Treatment of 
      Femoroacetabular Impingement and Labral Tears in Patients with Obesity: A 
      Match-Controlled Study.
PG  - 965-973
LID - 10.2106/JBJS.17.00892 [doi]
AB  - BACKGROUND: Obesity is a negative prognostic factor for various surgical 
      procedures. The purpose of this study was to compare patients with obesity who 
      underwent hip arthroscopy for femoroacetabular impingement and labral tears with 
      a match-controlled group of normal-weight patients. METHODS: Data were 
      prospectively collected and retrospectively reviewed for patients who underwent 
      arthroscopy between February 2008 and December 2011. Inclusion criteria were 
      treatment for femoroacetabular impingement and labral tears and completed 
      preoperative patient-reported outcomes and visual analog scale (VAS) for pain. 
      Exclusion criteria were previous ipsilateral hip conditions or preoperative 
      Tonnis grade of >/=2. Patients with obesity (body mass index [BMI] of >/=30 kg/m) 
      were matched and were compared with normal-weight patients (BMI of 18.5 to 24.99 
      kg/m) using a 1:1 ratio by age at the time of the surgical procedure within 5 
      years, sex, acetabular Outerbridge grade (0 or 1 compared with 2, 3, or 4), and 
      capsular treatment. RESULTS: Of the 96 obesity cases with follow-up, 74 were 
      pair-matched to control cases. The mean BMI was 34.3 kg/m for the obesity group 
      and 22.7 kg/m for the control group (p < 0.0001). The mean follow-up time was 
      71.6 months for the obesity group and 71.3 months for the control group (p = 
      0.41). All mean preoperative patient-reported outcomes and VAS scores for 
      patients without conversion to total hip arthroplasty were significantly worse in 
      the obesity group: modified Harris hip score (p = 0.0001), Non-Arthritic Hip 
      Score (p = 0.0001), Hip Outcome Score Sports-Specific Scale (HOS-SSS) (p = 
      0.015), and VAS (p = 0.01). No significant differences were observed with regard 
      to demographic characteristics, intraoperative findings, procedures, follow-up 
      scores, magnitudes of improvement, or secondary arthroscopy rates (p > 0.05). 
      Both groups demonstrated significant improvements in mean outcome scores at >/=5 
      years (p < 0.0001). In both groups, no significant differences were detected in 
      mean outcome scores between 2 years and >/=5 years (p > 0.05). The conversion rate 
      to total hip arthroplasty was 29.7% for the obesity group and 14.9% for the 
      control group (relative risk, 2.0 [95% confidence interval, 1.1 to 3.8]; p = 
      0.04). CONCLUSIONS: Hip arthroscopy for the treatment of femoroacetabular 
      impingement and labral tears in patients with obesity yielded significant 
      improvements at >/=5 years; these results were similar to a matched group of 
      normal-weight patients. However, patients with obesity demonstrated a twofold 
      increased risk of conversion to total hip arthroplasty. LEVEL OF EVIDENCE: 
      Prognostic Level III. See Instructions for Authors for a complete description of 
      levels of evidence.
FAU - Perets, Itay
AU  - Perets I
AD  - American Hip Institute, Westmont, Illinois.
AD  - Department of Orthopaedics, Hadassah Hebrew University Hospital, Jerusalem, 
      Israel.
FAU - Rybalko, Danil
AU  - Rybalko D
AD  - American Hip Institute, Westmont, Illinois.
FAU - Chaharbakhshi, Edwin O
AU  - Chaharbakhshi EO
AD  - American Hip Institute, Westmont, Illinois.
AD  - Loyola University College of Medicine, Maywood, Illinois.
FAU - Mu, Brian H
AU  - Mu BH
AD  - American Hip Institute, Westmont, Illinois.
FAU - Chen, Austin W
AU  - Chen AW
AD  - American Hip Institute, Westmont, Illinois.
FAU - Domb, Benjamin G
AU  - Domb BG
AD  - American Hip Institute, Westmont, Illinois.
AD  - Hinsdale Orthopaedics, Hinsdale, Illinois.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Bone Joint Surg Am
JT  - The Journal of bone and joint surgery. American volume
JID - 0014030
SB  - IM
MH  - Acetabulum/surgery
MH  - Adult
MH  - Aged
MH  - *Arthroscopy
MH  - Body Mass Index
MH  - Case-Control Studies
MH  - Female
MH  - Femoracetabular Impingement/complications/*surgery
MH  - Follow-Up Studies
MH  - Hip Joint/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Obesity/*complications
MH  - Pain Measurement
MH  - Patient Satisfaction
MH  - Reoperation
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2018/06/06 06:00
MHDA- 2019/09/10 06:00
CRDT- 2018/06/06 06:00
PHST- 2018/06/06 06:00 [entrez]
PHST- 2018/06/06 06:00 [pubmed]
PHST- 2019/09/10 06:00 [medline]
AID - 00004623-201806060-00009 [pii]
AID - 10.2106/JBJS.17.00892 [doi]
PST - ppublish
SO  - J Bone Joint Surg Am. 2018 Jun 6;100(11):965-973. doi: 10.2106/JBJS.17.00892.