Department of Orthopedic Surgery, New York University Langone Health, New York, New York, U.S.A.
Department of Orthopedic Surgery, New York University Langone Health, New York, New York, U.S.A..
Arthroscopy. 2024 Mar;40(3):732-741. doi: 10.1016/j.arthro.2023.06.035. Epub 2023 Jun 30.
To evaluate the impact of age, body mass index (BMI), and symptom duration on 5-year clinical outcomes among females following primary hip arthroscopy for femoroacetabular impingement syndrome (FAIS).
We conducted a retrospective review of a prospectively collected database of hip arthroscopy patients with a minimum 5-year follow-up. Patients were stratified by age (<30, 30-45, ≥45 years), BMI (<25.0, 25.0-29.9, ≥30.0), and preoperative symptom duration (<1 vs ≥1 year). Patient-reported outcomes were assessed using the modified Harris Hip Score (mHHS) and Non-Arthritic Hip Score (NAHS). Pre- to postoperative improvement in mHHS and NAHS was compared between groups using the Mann-Whitney U test or Kruskal-Wallis test. Hip survivorship rates and minimum clinically important difference (MCID) achievement rates were compared with Fisher exact test. Predictors of outcomes were identified using multivariable linear and logistic regression. P values <.05 were considered significant.
In total, 103 patients were included in the analysis with a mean age of 42.0 ± 12.6 years (range, 16-75) and mean BMI of 24.9 ± 4.8 (range, 17.2-38.9). Most patients had symptoms of duration ≥1 year (60.2%). Six patients (5.8%) had arthroscopic revisions, and 2 patients (1.9%) converted to total hip arthroplasty by 5-year follow-up. Patients with BMI ≥30.0 had significantly lower postoperative mHHS (P = .03) and NAHS (P = .04) than those with BMI <25.0. Higher BMI was associated with reduced improvement in mHHS (β = -1.14, P = .02) and NAHS (β = -1.34, P < .001) and lower odds of achieving the mHHS MCID (odds ratio [OR] = 0.82, P = .02) and NAHS MCID (OR = 0.88, P = .04). Older age was predictive of reduced improvement in NAHS (β = -0.31, P = .046). Symptom duration ≥1 year was predictive of higher odds of achieving the NAHS MCID (OR = 3.98, P = .02).
Female patients across a wide range of ages, BMIs, and symptom durations experience satisfactory 5-year outcomes following primary hip arthroscopy, but higher BMI is associated with reduced improvement in patient-reported outcomes.
Level III, retrospective comparative prognostic trial.
评估年龄、体重指数（BMI）和症状持续时间对女性初次髋关节镜治疗股骨髋臼撞击综合征（FAIS）后 5 年临床结果的影响。
我们对前瞻性收集的髋关节镜患者数据库进行了回顾性分析，随访时间至少为 5 年。患者按年龄（<30 岁、30-45 岁、≥45 岁）、BMI（<25.0、25.0-29.9、≥30.0）和术前症状持续时间（<1 年和≥1 年）分层。使用改良 Harris 髋关节评分（mHHS）和非关节炎髋关节评分（NAHS）评估患者报告的结果。使用 Mann-Whitney U 检验或 Kruskal-Wallis 检验比较组间 mHHS 和 NAHS 的术前到术后改善情况。使用 Fisher 确切检验比较髋关节生存率和最小临床重要差异（MCID）达标率。使用多变量线性和逻辑回归确定结局的预测因素。P 值<.05 被认为具有统计学意义。
共纳入 103 例患者进行分析，平均年龄为 42.0±12.6 岁（范围 16-75 岁），平均 BMI 为 24.9±4.8（范围 17.2-38.9）。大多数患者的症状持续时间≥1 年（60.2%）。6 例（5.8%）患者行关节镜翻修术，2 例（1.9%）患者在 5 年随访时转为全髋关节置换术。BMI≥30.0 的患者术后 mHHS（P=.03）和 NAHS（P=.04）明显低于 BMI<25.0 的患者。较高的 BMI 与 mHHS（β=-1.14，P=.02）和 NAHS（β=-1.34，P<.001）改善程度降低以及 mHHS（OR=0.82，P=.02）和 NAHS（OR=0.88，P=.04）MCID 达标率降低相关。年龄较大与 NAHS 改善程度降低相关（β=-0.31，P=.046）。症状持续时间≥1 年与 NAHS MCID 达标率升高相关（OR=3.98，P=.02）。
女性患者在年龄、BMI 和症状持续时间广泛的范围内接受初次髋关节镜治疗后，5 年的临床结局满意，但较高的 BMI 与患者报告结局的改善程度降低相关。
III 级，回顾性比较预后试验。
