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Obesity is associated with less favorable outcomes following hip arthroscopic surgery: a systematic review and meta-analysis

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

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 I2 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/m2. 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 (I2 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.

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Funding

No funding has been received for this study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Medicine, Kobe University, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Yuichi Kuroda, Shingo Hashimoto, Shinya Hayashi, Naoki Nakano, Takehiko Matsushita, Takahiro Niikura, Ryosuke Kuroda & Tomoyuki Matsumoto

  2. Department of Orthopaedic Surgery, St. Luke’s International Hospital, Tokyo, Japan

    Masayoshi Saito

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  1. Yuichi Kuroda
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  2. Shingo Hashimoto
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  4. Shinya Hayashi
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Correspondence to Yuichi Kuroda.

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Appendix 1: Search strategy (DOCX 19 KB)

167_2021_6435_MOESM2_ESM.tif

Appendix 2: Study search strategy according to Preferred Reporting Items for Systematic Reviews andMeta-analyses (PRISMA) guidelines (TIF 867 KB)

Appendix 3: The Methodological Index for Non-randomized Studies (MINORS) checklist. (DOCX 35 KB)

Appendix 4: The Newcastle-Ottawa Scale (NOS) for non-randomized studies (DOCX 35 KB)

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Kuroda, Y., Hashimoto, S., Saito, M. et al. Obesity is associated with less favorable outcomes following hip arthroscopic surgery: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 29, 1483–1493 (2021). https://doi.org/10.1007/s00167-021-06435-9

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  • DOI: https://doi.org/10.1007/s00167-021-06435-9

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