Emily Berzolla, Nicole D Rynecki, Griffith G Gosnell, Allison M Morgan, Daniel Kaplan, Thomas Youm
{"title":"肥胖患者10年患者报告的预后较差，在髋关节镜治疗股髋臼撞击综合征后转到全髋关节置换术的比率较高。","authors":"Emily Berzolla, Nicole D Rynecki, Griffith G Gosnell, Allison M Morgan, Daniel Kaplan, Thomas Youm","doi":"10.1016/j.arthro.2025.03.012","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate patient-reported outcomes (PROs) and survivorship in obese patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS) at 10-year follow-up.</p><p><strong>Methods: </strong>A retrospective review was conducted of patients who underwent arthroscopy for FAIS from 2011 to 2013. Patients were assessed at baseline, 1 month, 6 months, 1 year, 2 years, 5 years, and 10 years using the modified Harris hip score (mHHS) and nonarthritic hip score (NAHS). Patients were categorized on the basis of BMI into normal, overweight, and obese cohorts. Minimal clinically important difference (MCID) and patient-acceptable symptom state (PASS) were calculated for both PROs. Improvements from baseline were analyzed, and differences between groups were evaluated while controlling for age. Survival to revision surgery was assessed with Kaplan-Meier survival curves.</p><p><strong>Results: </strong>144 patients (65.2% female) with a mean age of 38.8 ± 13.0 years and an average follow-up of 11.6 (range: 10.0-13.8) years were included, and categorized into normal weight (59.7%), overweight (26.4%), and obese (13.9%). All groups showed significant improvement in PROs at 10 years compared to baseline (P = .007). Obese patients had lower postoperative scores (mHHS: 72.8 vs 90.1; P = .009; NAHS: 68.4 vs 88.6; P = .003) and improvement in scores from baseline (mHHS: 23.4 vs 37.7; P = .013; NAHS: 18.4 vs 40.0; P = .004) at 10-year follow-up, as well as lower achievement of mHHS PASS (60.0% vs 87.2%; P = .015), NAHS PASS (50.0% vs 89.5%; P < .001) and NAHS MCID (70.0% vs 93.0%; P = .008). Obese patients also had a higher rate of conversion to THA (17.4% vs 3.3%; P = .012). The overall complication rate was 4.2% compared to 10% in the obese group, with obese patients experiencing a superficial infection more frequently (P = .002).</p><p><strong>Conclusions: </strong>Although obese patients still have significantly improved outcomes compared to baseline, at 10-year follow-up they have inferior outcomes compared to nonobese patients and higher rates of conversion to THA.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4000,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Obese Patients Have Inferior 10-Year Patient-Reported Outcomes and Higher Rates of Conversion to Total Hip Arthroplasty After Hip Arthroscopy for Femoroacetabular Impingement Syndrome.\",\"authors\":\"Emily Berzolla, Nicole D Rynecki, Griffith G Gosnell, Allison M Morgan, Daniel Kaplan, Thomas Youm\",\"doi\":\"10.1016/j.arthro.2025.03.012\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To evaluate patient-reported outcomes (PROs) and survivorship in obese patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS) at 10-year follow-up.</p><p><strong>Methods: </strong>A retrospective review was conducted of patients who underwent arthroscopy for FAIS from 2011 to 2013. Patients were assessed at baseline, 1 month, 6 months, 1 year, 2 years, 5 years, and 10 years using the modified Harris hip score (mHHS) and nonarthritic hip score (NAHS). Patients were categorized on the basis of BMI into normal, overweight, and obese cohorts. Minimal clinically important difference (MCID) and patient-acceptable symptom state (PASS) were calculated for both PROs. Improvements from baseline were analyzed, and differences between groups were evaluated while controlling for age. Survival to revision surgery was assessed with Kaplan-Meier survival curves.</p><p><strong>Results: </strong>144 patients (65.2% female) with a mean age of 38.8 ± 13.0 years and an average follow-up of 11.6 (range: 10.0-13.8) years were included, and categorized into normal weight (59.7%), overweight (26.4%), and obese (13.9%). All groups showed significant improvement in PROs at 10 years compared to baseline (P = .007). Obese patients had lower postoperative scores (mHHS: 72.8 vs 90.1; P = .009; NAHS: 68.4 vs 88.6; P = .003) and improvement in scores from baseline (mHHS: 23.4 vs 37.7; P = .013; NAHS: 18.4 vs 40.0; P = .004) at 10-year follow-up, as well as lower achievement of mHHS PASS (60.0% vs 87.2%; P = .015), NAHS PASS (50.0% vs 89.5%; P < .001) and NAHS MCID (70.0% vs 93.0%; P = .008). Obese patients also had a higher rate of conversion to THA (17.4% vs 3.3%; P = .012). 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引用次数: 0
摘要
目的：本研究的目的是评估接受髋关节镜治疗股髋臼撞击综合征（FAIS）的肥胖患者在10年随访期间的患者报告结局（PROs）和生存率。方法：对2010-2013年接受关节镜治疗的FAIS患者进行回顾性分析。采用改良的Harris髋关节评分（mHHS）和非关节炎髋关节评分（NAHS）对患者进行基线、1个月、6个月、1年、2年、5年和10年的评估。根据BMI将患者分为正常组、超重组和肥胖组。计算两种PROs的最小临床重要差异（MCID）和患者可接受症状状态（PASS）。在控制年龄的情况下，分析了从基线开始的改善情况，并评估了组间差异。通过Kaplan-Meier生存曲线评估到翻修手术的生存率。结果：144例患者（女性占65.2%），平均年龄38.8±13.0岁，平均随访11.6年（10.0 ~ 13.8年），分为体重正常（59.7%）、超重（26.4%）、肥胖（13.9%）。与基线相比，所有组在10年时的PROs均有显著改善（p=0.007）。肥胖患者术后评分较低(mHHS: 72.8比90.1,p=0.009；NAHS: 68.4 vs..88.6, p=0.003)和评分较基线的改善(mHHS: 23.4 vs. 37.7, p=0.013；NAHS: 18.4 vs. 40.0, p=0.004)，以及mHHS PASS （60.0% vs. 87.2%, p=0.015）和NAHS PASS （50.0% vs. 89.5%）的较低成就。结论：尽管肥胖患者的结局与基线相比仍有显著改善，但在10年随访时，他们的结局与非肥胖患者相比较差，转成THA的比率较高。证据等级：III级，回顾性比较研究。
Obese Patients Have Inferior 10-Year Patient-Reported Outcomes and Higher Rates of Conversion to Total Hip Arthroplasty After Hip Arthroscopy for Femoroacetabular Impingement Syndrome.
Purpose: To evaluate patient-reported outcomes (PROs) and survivorship in obese patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS) at 10-year follow-up.
Methods: A retrospective review was conducted of patients who underwent arthroscopy for FAIS from 2011 to 2013. Patients were assessed at baseline, 1 month, 6 months, 1 year, 2 years, 5 years, and 10 years using the modified Harris hip score (mHHS) and nonarthritic hip score (NAHS). Patients were categorized on the basis of BMI into normal, overweight, and obese cohorts. Minimal clinically important difference (MCID) and patient-acceptable symptom state (PASS) were calculated for both PROs. Improvements from baseline were analyzed, and differences between groups were evaluated while controlling for age. Survival to revision surgery was assessed with Kaplan-Meier survival curves.
Results: 144 patients (65.2% female) with a mean age of 38.8 ± 13.0 years and an average follow-up of 11.6 (range: 10.0-13.8) years were included, and categorized into normal weight (59.7%), overweight (26.4%), and obese (13.9%). All groups showed significant improvement in PROs at 10 years compared to baseline (P = .007). Obese patients had lower postoperative scores (mHHS: 72.8 vs 90.1; P = .009; NAHS: 68.4 vs 88.6; P = .003) and improvement in scores from baseline (mHHS: 23.4 vs 37.7; P = .013; NAHS: 18.4 vs 40.0; P = .004) at 10-year follow-up, as well as lower achievement of mHHS PASS (60.0% vs 87.2%; P = .015), NAHS PASS (50.0% vs 89.5%; P < .001) and NAHS MCID (70.0% vs 93.0%; P = .008). Obese patients also had a higher rate of conversion to THA (17.4% vs 3.3%; P = .012). The overall complication rate was 4.2% compared to 10% in the obese group, with obese patients experiencing a superficial infection more frequently (P = .002).
Conclusions: Although obese patients still have significantly improved outcomes compared to baseline, at 10-year follow-up they have inferior outcomes compared to nonobese patients and higher rates of conversion to THA.
Level of evidence: Level III, retrospective comparative study.
期刊介绍：
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