Total Hip Arthroplasty in Young and Obese Patients

Abstract

Special attention should be drawn on endoprosthetic hip replacement in young and obese patients because of an increased risk of perioperative complications and early implant failure. Gain of function and reduction of pain are not compromised in these patients, so that the indication criteria remain unchanged. Implant survival is reduced in very young patients and mainly influenced by the bearing materials. The risk of implant malalignment, specifically of the cup, can be minimized by an intraoperative X-ray control. The effect of bariatric surgery on perioperative complications remains unclear. But a preoperatively uncontrolled diabetes increases the risk of infection. Known specific risk factors of young and obese patients should be considered during the perioperative management and be included in the individual operation planning and informed consent.

Instability in Total Hip Arthroplasty

“…Patients with elevated BMI tend to be younger. Younger aged patients statistically place more stress on their implants and with the increased weight these patients may have elevated wear rates and higher risk of aseptic loosening [24].…”