Short-term Outcomes of Hip Arthroscopy for the Treatment of Femoroacetabular Impingement and Labral Tears in Underweight Patients.

Abstract

Being underweight or malnourished has been recognized as an adverse prognostic factor in various surgical orthopaedic interventions. (1) To report minimum 2-year outcomes of underweight patients who underwent primary hip arthroscopy for femoroacetabular impingement (FAI) and labral tears and (2) to compare these results with a propensity-matched control group of patients with normal weight. Case series; Level of evidence, 4. Data were retrospectively analyzed for patients with a body mass index (BMI) ≤18.5 kg/m² who underwent primary hip arthroscopy by the senior surgeon at a single institution as treatment for FAI and labral tears between August 2008 and January 2022. Included patients had complete pre- and postoperative patient-reported outcomes (PROs) and visual analog scale (VAS) score for pain at minimum 2-year follow-up. Clinically important thresholds for hip arthroscopy, revision surgery, and conversion to total hip arthroplasty were included in the analysis. Patients were propensity matched to a control group of normal weight patients (BMI, 18.6-24.99 kg/m²) in a 1:2 ratio based on sex, age at surgery, acetabular Outerbridge grade, labral treatment, and capsular treatment. A total of 234 patients were included in the study. Underweight patients displayed significant improvements across all PROs and high patient satisfaction. When underweight patients were compared with a benchmark control group, similar magnitudes of improvement were observed at a minimum 2-year follow-up for modified Harris Hip Score, Nonarthritic Hip Score, International Hip Outcome Tool-12, and VAS. Furthermore, the study cohort had a lower magnitude of improvement for the Hip Outcome Score-Sports-Specific Subscale (HOS-SSS) (<i>P</i> < .05). The study group reached Patient Acceptable Symptom State for HOS-SSS at lower rates. Underweight patients had a higher frequency of revision hip arthroscopy with a relative risk of 2.16 (<i>P</i> < .05). Hip arthroscopy for the treatment of FAI and labral tear in underweight patients yielded significant short-term improvements in PROs, which, except for postoperative VAS pain score and change in HOS-SSS, were comparable with a benchmark matched control group of normal weight patients. However, underweight patients had a 2.16-fold increased relative risk for revision hip arthroscopy. Underweight patients may benefit from preoperative nutritional evaluation.