Hip arthroscopy in obese, a successful combination?

Abstract

Discussion persists about the outcome and results of hip arthroscopy in obese patients. Hip arthroscopy gained popularity over time. A current discussion is if obese patients can reach similar results after surgery compared with non-obese. To our knowledge, this is the first systematic review of literature about hip arthroscopy and obesity. We searched the Pubmed/Medline databases for literature and included three studies that compared the outcome of hip arthroscopy between different BMI groups. We extracted and pooled the data. For continues data a weighted mean difference was calculated, for dichotomous variables a weighted odds ratio (OR) was calculated using Review Software Manager. Heterogeneity of the included studies was calculated using I2 statistics. Data were extracted from two studies. In the Obese group, there was significant more conversion to total hip replacement or resurfacing hip replacement (OR = 2.21, 95% CI 1.07–4.56) and more re-arthroscopy (OR = 4.68, 95% CI 1.41–15.45). Any reoperation occurred more often in the obese group (OR = 2.87, 95% CI 1.53–5.38). In the Non Arthritic Hip Score obese scored lower than the non-Obese group [10.9 (−14,6 to 7.1)]. For the modified Harris Hip Score the score is − 6,6, according to the MCID this difference is clinically relevant. For both scores obese show lower outcomes but similar improvement after hip arthroscopy. Regarding a higher chance of needing a re-operation and lower subjective outcome scores obesity appears to have a negative influence on the outcome of hip arthroscopy.

Progression to total hip arthroplasty following hip arthroscopy

“…This finding differs from that of Schairer et al . who found an independent influence of obesity (OR: 2.4) and the meta‐analysis by Bech et al . which reported (OR: 2.2).…”

Arthroplasty versus Internal Fixation for Displaced Intracapsular Femoral Neck Fracture in the Elderly

“…The Harris hip score difference between AR and IF in the present study was 3.6 points at 2 years postoperatively, which is less than the minimal clinically important difference of 4 points,[43] suggesting AR might not be preferential to IF in terms of overall functional recovery.…”

Developing a risk prediction model for the functional outcome after hip arthroscopy

“…Previous studies show there is evidence that demographic factors such as age, BMI and duration of symptoms can be predictors of outcome after hip arthroscopy, but are inconsistent [ 7 , 9 – 11 , 13 – 15 , 34 , 35 ]. Our model does not show this predictive relationship either.…”