No abstract

Although the effect of being overweight on the long-and short-term outcome of THA remains unclear, the majority of orthopaedic surgeons believe being overweight negatively influences the longevity of a hip implant. We asked whether complications and long-term survival of cemented THA differed in overweight patients (body mass index [BMI] [ 25 kg/m 2 ) and obese patients (BMI [ 30 kg/m 2 ) compared with normal-weight patients (BMI \ 25 kg/m 2 ). We retrospectively analyzed 411 consecutive patients (489 THAs) treated with cemented THA between 1974 and 1993. Except for cardiovascular comorbidity, we observed no differences in demographics among these weight groups. We found no differences in the number of intraoperative or postoperative complications. The survival rates for the three BMI groups were similar. The 10-year survival for any revision was 94.9% (95% confidence interval, 91.6%-98.2%), 90.4% (95% confidence interval, 85.6%-95.2%), and 91% (95% confidence interval, 81.2%-100%) for normal-weight, overweight, and obese patients, respectively. Cox regression analysis showed BMI and weight had no major influence on survival rates. The differences in mean Harris hip score at final followup were 4.8 between normal-weight and overweight patients and 7

We evaluated the long-term results of 116 total hip replacements with a superolateral shelfplasty in 102 patients with osteoarthritis secondary to developmental dysplasia of the hip. After a mean follow-up of 19.5 years (11.5 to 26.0), 14 acetabular components (12%) had been revised. The cumulative survival at 20 years was 78%, with revision for loosening of the acetabular component as the end-point. All grafts were well integrated and showed remodelling. In six grafts some resorption had occurred under the heads of the screws where the graft was not supporting the socket. Apart from these 14 revisions, seven acetabular components had possible radiological signs of loosening at a mean follow-up of 14.5 years, one had signs of probable loosening, and five had signs of definite loosening. These results indicate that this technique of bone grafting for acetabular reconstruction in hip dysplasia is a durable solution for cemented acetabular components.

Therapeutic study, Level III (retrospective comparative study). See the Guidelines for Authors for a complete description of levels of evidence.