Obesity in total hip replacement

Abstract

A prospective, multi-centre study was carried out on 1421 total hip replacements between January 1999 and July 2007 to examine if obesity has an effect on clinical outcomes. The patients were categorised into three groups: non-obese (body mass index (BMI) < 30 kg/m(2)), obese (BMI 30 to 40 kg/m(2)) and morbidly obese (BMI > 40 kg/m(2)). The primary outcome measure was the change in Oxford hip score at five years. Secondary outcome measures included dislocation and revision rates, increased haemorrhage, deep infection, deep-vein thrombosis and pulmonary embolism, mean operating time and length of hospital stay. Radiological analysis assessing heterotopic ossification, femoral osteolysis and femoral stem positioning was performed. Data were incomplete for 362 hips (25.5%) There was no difference in the change in the Oxford hip score, complication rates or radiological changes at five years between the groups. The morbidly obese group was significantly younger and required a significantly longer operating time. Obese and morbidly obese patients have as much to gain from total hip replacement as non-obese patients.

Dual-mobility or Constrained Liners Are More Effective Than Preoperative Bariatric Surgery in Prevention of THA Dislocation

“…Given the association between BMI and development of hip osteoarthritis [1], THAs will be performed on an increasing number of patients with obesity. Of particular concern is the risk of dislocation in patients with obesity when using a posterior approach and when the BMI is greater than 35 kg/m 2 [2,6,14,18,28,35,36]. The specific frequency and the best approaches for preventing this serious complication are unclear [4,21,32,39].…”

“…When obesity is defined as a body mass index (BMI) greater than 30 kg/m 2 in adults, obesity is recognized as an independent risk factor for postoperative hip dislocation in several studies [2,6,8,15,18,22,28,35]. However, in these patients with obesity, it is not known whether the risk is only in the early postoperative period or if the risk persists several years after surgery.…”

Obese patients may have more soft tissue impingement following primary total hip arthroplasty

“…Several studies have attempted to clarify the interaction between obesity and dislocation following THA [14][15][16]. Azodi et al demonstrated that a high body mass index (BMI) increased the risk of dislocation after THA [16].…”

“…Azodi et al demonstrated that a high body mass index (BMI) increased the risk of dislocation after THA [16]. In particular, morbidly obese patients (BMI >40) had a statistically significant higher risk of dislocation [3,15]. By contrast, other studies did not find evidence of an increased rate of dislocation caused by obesity after THA [14,15].…”

Hip osteoarthritis surgical profiles and morbid obesity: a case series and literature review

“…Moreover, associated high rates of pain, as well as joint destruction and postural changes in those who are excessively obese can be expected to impact the pathogenesis of hip joint osteoarthritis both before and after surgery more profoundly than non-obese situations [18,19]. Alternately, the constellation of obesity, immobility and pain can independently raise the risk for hip joint osteoarthritis, and its disability [21][22][23][24][25][26][27][28][29][30][31].…”