Collins Jason A, Beutel Bryan G, Garofolo Garret, Youm Thomas
Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York, U.S.A.
Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York, U.S.A..
Arthroscopy. 2015 Jan;31(1):57-62. doi: 10.1016/j.arthro.2014.07.013. Epub 2014 Sep 11.
This study aimed to evaluate patient-reported outcomes and complications after hip arthroscopy in an obese population compared with a matched nonobese control group with a minimum 2-year follow-up, using the Modified Harris Hip Score (MHHS) and Nonarthritic Hip Score (NAHS).
Data were analyzed from 21 consecutive obese patients (body mass index [BMI] ≥ 30) and 18 nonobese patients (BMI < 25) who underwent hip arthroscopy between 2009 and 2012 with a minimum follow-up of 2 years. Data collected included MHHS, NAHS, traction and intraoperative times, and postoperative complications.
Traction times were similar between obese and nonobese patients at 48 and 45 minutes (P = .51), respectively. Operative times were also similar at 54 and 51 minutes (P = .79), respectively. Each group had a statistically significant improvement in MHHS from baseline to final follow-up: 45 to 79 (P < .001) in the obese group and 49 to 81 (P < .001) in the nonobese cohort. Similarly, the NAHS showed significant improvement in each group from baseline to final follow-up: 43 to 75 (P < .001) in the obese cohort and 45 to 83 (P < .001) in the nonobese group. There was no difference between groups in MHHS or NAHS data. There were 8 complications in the obese group, most commonly deep vein thrombosis (DVT) and worsened pain, whereas the nonobese cohort had one complication (an instance of heterotopic ossification [HO]). Overall, obese patients had 11.1 times the risk of a complication developing than did nonobese patients (95% confidence interval, 1.2 to 99.7).
Hip arthroscopy in the obese patient population leads to improved short- to mid-term patient-reported outcomes similar to those seen in nonobese patients. Obese patients, however, are at a significantly increased risk of postoperative complications such as DVTs and worsened hip pain.
Level IV, therapeutic case series.
本研究旨在通过改良Harris髋关节评分（MHHS）和非关节炎髋关节评分（NAHS），评估肥胖人群与匹配的非肥胖对照组在接受髋关节镜检查后至少2年随访期内的患者报告结局和并发症情况。
分析了2009年至2012年间连续接受髋关节镜检查的21例肥胖患者（体重指数[BMI]≥30）和18例非肥胖患者（BMI<25）的数据，随访期至少2年。收集的数据包括MHHS、NAHS、牵引时间和手术时间以及术后并发症。
肥胖患者和非肥胖患者的牵引时间分别为48分钟和45分钟，相似（P = 0.51）。手术时间分别为54分钟和51分钟，也相似（P = 0.79）。从基线到最终随访，每组的MHHS均有统计学显著改善：肥胖组从45提高到79（P < 0.001），非肥胖组从49提高到81（P < 0.001）。同样，从基线到最终随访，每组的NAHS均有显著改善：肥胖组从43提高到75（P < 0.001），非肥胖组从45提高到83（P < 0.001）。两组在MHHS或NAHS数据上无差异。肥胖组有8例并发症，最常见的是深静脉血栓形成（DVT）和疼痛加重，而非肥胖组有1例并发症（异位骨化[HO]1例）。总体而言，肥胖患者发生并发症的风险是非肥胖患者的11.1倍（95%置信区间，1.2至99.7）。
肥胖患者人群的髋关节镜检查可使患者报告的短期至中期结局得到改善，与非肥胖患者相似。然而，肥胖患者术后发生DVT和髋关节疼痛加重等并发症的风险显著增加。
IV级，治疗性病例系列。
