Short-term Outcomes of Hip Arthroscopy for the Treatment of Femoroacetabular Impingement and Labral Tears in Underweight Patients.
Authors
Quesada-Jimenez R, Keane JC, Kahana-Rojkind AH, Kingham YE, Strok MJ, Domb BG
Background
Underweight or malnourished status is known to be a risk factor for poorer outcomes following various orthopedic procedures. However, data are limited on how being underweight affects recovery and outcomes after hip arthroscopy for femoroacetabular impingement (FAI) and labral tears.
Methods
This retrospective case series evaluated 234 patients who underwent primary hip arthroscopy for FAI and labral tears between 2008 and 2022. The study group included underweight patients (BMI ≤18.5 kg/m²), with at least 2 years of postoperative follow-up and complete pre- and post-op patient-reported outcomes (PROs) and visual analog scale (VAS) pain scores. These patients were propensity matched 1:2 to a control group of normal-weight individuals (BMI 18.6–24.99 kg/m²) based on sex, age, labral and capsular treatment, and acetabular Outerbridge grade.
Key Findings
- Underweight patients experienced significant improvements in all PROs and reported high satisfaction.
- When compared with normal-weight controls, underweight patients showed similar improvements in:
- Modified Harris Hip Score (mHHS)
- Nonarthritic Hip Score (NAHS)
- International Hip Outcome Tool-12 (iHOT-12)
- VAS for pain
- However, they had a significantly lower magnitude of improvement in HOS-SSS (p < .05).
- They also reached Patient Acceptable Symptom State (PASS) for HOS-SSS at lower rates.
- Underweight patients had a 2.16-fold higher risk of requiring revision hip arthroscopy (p < .05).
Conclusion
While underweight patients can achieve meaningful short-term improvements after hip arthroscopy for FAI and labral tears, they are at greater risk for revision surgery and demonstrate inferior sports-specific functional gains compared to normal-weight individuals. These findings suggest the importance of considering nutritional status in preoperative planning.
What Does This Mean For Patients
Patients with low body weight can still benefit from hip arthroscopy, but they may be more likely to need a second surgery and may have more limited improvement in sports-related activities. A preoperative nutritional assessment may help optimize outcomes.