Obesity is associated with less favorable outcomes following hip arthroscopic surgery: a systematic review and meta‐analysis
Yuichi Kuroda, Shingo Hashimoto, Masayoshi Saito, Shinya Hayashi, Naoki Nakano, Takehiko Matsushita, Takahiro Niikura, Ryosuke Kuroda, Tomoyuki Matsumoto
Abstract
Abstract Purpose The aim of this study was to systematically review the existing literature comparing the postoperative outcomes after following hip arthroscopy in obese and non‐obese patients. Methods Studies comparing the outcomes following hip arthroscopy of obese and non‐obese patients were systematically identified via a computer‐assisted literature search of Pubmed (Medline), EMBASE, and Cochrane Library using the preferred reporting items for systematic reviews and meta‐analyses (PRISMA) guidelines. Studies comparing the outcome of hip arthroscopy in different body mass index (BMI) groups were included. Data including patient‐reported outcome measures (PROMs), revision arthroscopy rate, conversion rate to total hip arthroplasty (THA), and complications were collected. The methodological index for non‐randomized studies (MINORS) and Newcastle–Ottawa Scale (NOS) were used to assess the quality of each study quality. The effect of heterogeneity was quantified by calculating the I 2 value. Results A total of eight studies were finally included in the qualitative analysis, and three studies of high quality involving 373 hips were included in the quantitative assessment. All the studies defined obesity as a BMI of ≥ 30 kg/m 2 . The modified Harris Hip Score and the Non‐Arthritic Hip Score were 5.1 (95% CI 1.1–9.1) and 9.0 (95% CI 5.0–13.1) points lower, respectively, in the obese group than in the non‐obese group. The pooled odds ratios were 1.2 (95% CI 0.5–2.7) for revision arthroscopy, 2.4 (95% CI 1.3–4.6) for conversion to THA, and 3.2 (95% CI 1.2–8.6 for complications in favor of the non‐obese group. The heterogeneity was low in all outcome assessments ( I 2 0–18%). Conclusion Obese patients had significantly lower PROMs than non‐obese patients following hip arthroscopic surgery, and the THA conversion and complication rates were 2.4 times and 3.2 times higher, respectively. Understanding the effect of obesity on hip arthroscopy will allow appropriate surgical indications for surgery to be further refined and help obese patients to understand their individual risk profile. Level of evidence Systematic review of Level III–IV studies, Level IV.