Obese Patients Treated by Hip Arthroscopy for Femoroacetabular Impingement Syndrome — 10-Year Functional Outcomes and Conversion Rates to Arthroplasty Compared With Normal-Weight Patients

Background: Obesity is a recognized adverse prognostic factor across various surgical interventions. Purpose: To evaluate long-term outcomes in patients with obesity who underwent hip arthroscopy for femoroacetabular impingement (FAI) and labral tears, compared with a control group with normal weight. Study Design: Retrospective cohort study; Level of evidence, 3. Methods: This was a prospectively matched cohort study. Data were analyzed for patients who underwent primary hip arthroscopy for FAI and labral tears between October 2008 and October 2013, with a body mass index (BMI) of ≥30 kg/m 2 . Included patients had completed pre- and postoperative patient-reported outcomes (PROs) and visual analog scale (VAS) questionnaires at a minimum 10-year follow-up or a documented endpoint within the study time. Rates of revision surgery and survivorship were compared. A subanalysis was performed based on BMI subgroups, and a secondary subanalysis was conducted based on sex. Patients were propensity-matched to a control group of normal-weight patients (BMI, 20-24.99 kg/m 2 ) in a 1 to 1 ratio by sex, age at surgery, acetabular Outerbridge grade, and capsular treatment. Results: A total of 266 patients were included in the study, with a mean follow-up time of 125.19 ± 43.07 months. The 2 groups demonstrated similar magnitudes of improvement at 10-year follow-up for the Non-Arthritic Hip Score (NAHS), Hip Outcome Score–Sport-Specific Subscale (HOS-SSS), and visual analog scale for pain (VAS-Pain), achieving comparable postoperative scores. The 2 groups achieved the minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) for the modified Harris Hip Score (mHHS), NAHS, and HOS-SSS at similar rates ( P 2-fold odds of conversion to THA. Patients with morbid obesity achieved clinical thresholds at lower rates and should therefore be approached with caution.