Lower body mass index and symptom burden in modern hip arthroscopy patients: Updated epidemiology and trends from the MASH multicenter cohort.

Overview

abstract

PURPOSE: The present study aims to describe epidemiological, diagnostic and surgical data for a large group of patients undergoing hip arthroscopy between 2018 and 2023. We also explore how these trends compare to previous cohorts, particularly the 2014-2017 Multicenter Arthroscopic Study of the Hip (MASH) study. In response to the rapid growth of hip arthroscopy literature, we hypothesize that surgeons are operating on patients with a lower average body mass index (BMI), younger age, less severe reported symptoms at the time of surgery, and shorter preoperative symptom duration. METHODS: The MASH database was searched for patients who underwent hip arthroscopy for treatment of FAI between 2018 and 2023, and had demographic data available in the registry. Standardized data included demographics, symptoms, imaging, intraoperative diagnoses (labral tears, cartilage lesions) and patient-reported outcome measures (International Hip Outcome Tool 12-item [iHOT-12], modified Harris Hip Score [mHHS], HOS, Visual Analogue Scale, 12-item Short Form Health Survey, Patient-Reported Outcomes Measurement Information System). RESULTS: Our study found that patients who elected to undergo hip arthroscopy between 2018 and 2023 at eight different US-based sites were, on average, 34.3 years old with a body mass index of 25.0 kg/m². The majority experienced symptoms for at least 4 months (91.4%), with 33.4% reporting symptoms lasting over 2 years. Symptoms were frequently exacerbated by athletic activities (86.6%) and sitting (63.8%). Prior to surgery, patients reported substantial functional limitations and impaired well-being, with a mean iHOT-12 score of 38.7 and a mHHS of 56.0. At 2-year follow-up, 85.9% and 76.4% of patients reached our distribution-based minimal clinically important difference value for mHHS and iHOT-12, respectively. CONCLUSION: This multicenter data set has demonstrated improved patient-reported symptoms at the time of surgery, a decrease in mean patient BMI, and an increase in symptom duration reported prior to surgery. This data provides a contemporary benchmark for hip arthroscopy patient characteristics, reaffirms the efficacy of hip arthroscopy, and indicates earlier and more effective diagnosis of abnormal hip morphology. LEVEL OF EVIDENCE: Level IV.