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Hip

DOES BMI AFFECT OUTCOME AFTER HIP PRESERVATION SURGERY? A STUDY USING THE UK NON-ARTHROPLASTY HIP REGISTRY DATASET

The British Hip Society (BHS) Annual Scientific Meeting, Newport, Wales, March 2020.



Abstract

Background

This study aimed to investigate the effect of body mass index (BMI) on functional outcome following hip preservation surgery using the U.K. Non-Arthroplasty Hip Registry (NAHR).

Methods

Data on adult patients who underwent hip arthroscopy or periacetabular osteotomy (PAO) between January 2012 and December 2018 was extracted from the UK Non-Arthroplasty Hip Registry dataset allowing a minimum of 12 months follow-up. Data is collected via an online clinician and patient portal. Outcomes comprised EuroQol-5 Dimensions (EQ-5D) index and the International Hip Outcome Tool 12 (iHOT-12), preoperatively and at 6 and 12 months

Results

A total of 6,666 patients were identified with BMI data available in 52%, comprising 3,220 arthroscopies and 277 PAO. Patients were divided into WHO groups: <25kg/m2 (n=1,745 (49.8%)), 25–30kg/m2 (n=1,199 (34.2%)), and ≥30kg/m2 (n=562 (16.0%)). Patients with higher BMI tended to be older. Pre-operative, 6 and 12-month follow-up were available for 91%, 49% and 45% of cases respectively. Higher BMI was associated with significantly poorer baseline, 6- and 12-month outcomes (12-month mean iHOT-12 score: <25kg/m2 = 62.3 (95%CI 60.4 to 64.3), 25–30kg/m2 = 57.3 (95%CI 55.0 to 59.7), ≥30kg/m2 = 54.7 (95%CI 51.1 to 58.2)). However, all groups saw similar and statistically significant improvement in pre- vs post-op scores (mean 12-month iHOT-12 gain: <25kg/m2 = +27.1 (95%CI 25.1 to 29.0), 25–30kg/m2 = +26.5 (95%CI 24.0 to 29.0), ≥30kg/m2 = +26.8 (95%CI 23.2 to 30.4), between-group p = 0.9). EQ-5D outcomes followed the same trend. Modelling for age, sex and procedure we found no significant difference in 12-month iHOT-12 gain between BMI groups.

Conclusion

Whilst obese patients started from, and achieved lower post-operative raw functional scores, all BMI groups saw similar and significant degrees of improvement in functional outcome post-operatively. Obesity should not be considered a contraindication to hip preservation surgery.


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