Does Obesity Affect Outcomes in Hip Arthroscopy? A Matched-Pair Controlled Study with 2-year Minimum Follow-up
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1 Does Obesity Affect Outcomes in Hip Arthroscopy? A Matched-Pair Controlled Study with 2-year Minimum Follow-up Asheesh Gupta, MD 1 John M. Redmond MD 1,3 Jon E. Hammarstedt, BS 1 Christine E. Stake, DHA 1 Benjamin G. Domb, MD 1,2 1. American Hip Institute, 2., 3. Mayo Clinic Jacksonville
2 Disclosures Dr. Benjamin Domb American Hip Institute Research support: o American Hip Institute o Arthrex, Inc. o Mako Surgical Corp. o Breg o ATI o Pacira Consulting: o Arthrex, Inc. o Mako Surgical Corp. o Pacira Stock: o Stryker Royalties: o Arthrex, Inc. o Orthomerica o DJO Global AANA Learning Center Committee Boardmember of American Hip Institute
3 Background Obesity: Increasing rates Poorer outcomes in several orthopedic surgeries Greater risk of surgical site infections
4 Hip Biomechanics Joint reaction force reaches 3-6 times body weight Multiple muscles cross at the joint Excess weight increases demand
5 Purpose Compare two-year clinical outcomes of obese patients undergoing hip arthroscopy to a matched group of normal weight patients
6 Methods Study period: 2/2008 2/2012 Inclusion criteria: o Primary hip arthroscopy o Minimum two-year FU o Radiographs pre and post surgery Exclusion criteria: o Revisions o Previous hip conditions
7 PROs Patient reported outcomes included: Modified Harris hip score (mhhs) Non-arthritic hip score (NAHS) Hip outcome score activities of daily living (HOS-ADL), and sports specific subscale (HOS- SSS). Visual analog scale (VAS)
8 Obesity Categories Normal weight group BMI <25 Obese group BMI >30 Matched pair group was on 2:1 ratio (normal to obese)
9 Matching Criteria
10 Radiographic Measurements
11 Surgical Procedures
12 Results Obese hips=62 Normal weight hips=124 72% Female Average age=42 o No differences in ages between groups Mean BMIs o Obese=33.1 kg/m 2 o Normal=22.7 kg/m 2
13 Results - Outcomes Obese patients: o Significantly lower flexion & internal rotation (p<.05) o Pre-operative PRO scores significantly lower Both groups demonstrated significant improvement in pre to post-op scores (p<.001) No significant difference for delta, or amount of change in scores between groups
14 Results
15
16 Complications & Endpoints Postoperative infections: o 2-normal weight; 3-obese Heterotopic ossification o 0-normal weight; 1-obese Revision Surgery o 5-normal weight; 5-obese Conversion to THA o 6-normal weight; 6-obese
17 Conclusion Obese patients overall lower absolute PRO scores pre-operatively and at 2Y FU Both groups demonstrated significant improvements in all PROs Delta between scores similar between groups Expectations should be adjusted for obese patients
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