Trends in obesity prevalence among total hip arthroplasty patients and the effect on surgical outcomes, 2008–2016

Pirruccio, Kevin; Sloan, Matthew; Sheth, Neil P.

doi:10.1016/j.jor.2019.03.024

Cited by 21 publications

(21 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While a body mass index (BMI) exceeding 30 kg/m 2 is not a true reflection of general state of health or fitness level, the medical co-morbidities of obesity (BMI!30 kg/m 2 ) are well documented, and there is an association with the development of hip osteoarthritis 2,3 . The increase in BMI across our population has implications for both the numbers of hip and knee arthroplasties being performed but also for subsequent outcomes 1,4 .…”

Section: Introductionmentioning

confidence: 99%

Greater risks of complications, infections, and revisions in the obese versus non-obese total hip arthroplasty population of 2,190,824 patients: a meta-analysis and systematic review

Onggo

Steiger

et al. 2020

Osteoarthritis and Cartilage

View full text Add to dashboard Cite

Background: Obesity is an epidemic, especially in developed countries. This affects the general health of these patients, especially when they are having a major surgical procedure such as total hip arthroplasty (THA). Several articles have described the effects of obesity on THA with varying conclusions. This metaanalysis aims to compare the outcomes, complications, and peri-operative parameters of THA in the obese (BMI!30 kg/m 2) vs non-obese (BMI<30 kg/m 2) population as well as a subgroup analysis of morbidly obese (BMI!40 kg/m 2) vs non-obese population. Methods: A multi-database search was performed according to PRISMA guidelines. Data from studies assessing the outcomes and complications of THA in the obese and non-obese population were extracted and analyzed. Results: Sixty-seven studies were included in this meta-analysis, consisting of 581,012 obese and 1,609,812 non-obese patients. Meta-analysis could not be performed on patient reported outcome measures due to heterogeneous reporting methods. Obese patients had a higher risk of all complications (OR ¼ 1.53, 95%CI: 1.30e1.80, P < 0.001), deep infections (OR ¼ 2.71, 95%CI: 2.08e3.53, P < 0.001), superficial infections (OR ¼ 1.99, 95%CI: 1.55e2.55, P < 0.001), dislocations (OR ¼ 1.72, 95%CI: 1.66e1.79, P < 0.001), reoperations (OR ¼ 1.61, 95%CI: 1.40e1.85, P < 0.001), revisions (OR ¼ 1.44, 95%CI: 1.32e1.57, P < 0.001), and readmissions (OR ¼ 1.37, 95%CI: 1.15e1.63, P < 0.001). When subgroup analysis of morbidly obese (BMI!40 kg/m 2) patients was performed, the risks of all these parameters were even greater. Conclusion: Obese and morbidly obese patients are at higher risks of complications post THA than nonobese patients. Surgeons should be aware of these risks in order to counsel patients and adopt prophylactic strategies to reduce these risks where applicable.

show abstract

Section: Introductionmentioning

confidence: 99%

Greater risks of complications, infections, and revisions in the obese versus non-obese total hip arthroplasty population of 2,190,824 patients: a meta-analysis and systematic review

Onggo

Steiger

et al. 2020

Osteoarthritis and Cartilage

View full text Add to dashboard Cite

show abstract

“…There is a rising rate of obesity in the United States. In an investigation of the American College of Surgeons National Surgical Quality Improvement Program database, Pirruccio et al [4] identified an increase in the prevalence of obesity in total hip arthroplasties (THAs) from 45.5% in 2008 to 47.1% in 2016. Correspondingly, we can continue to expect more patients presenting with musculoskeletal consequences from obesity including osteoarthritis and debilitating joint pain.…”

mentioning

confidence: 99%

Fate of the Morbidly Obese Patient Who Is Denied Total Joint Arthroplasty

Shapiro

Narayanan

Taylor

et al. 2020

The Journal of Arthroplasty

View full text Add to dashboard Cite

Background: The purpose of this study is to investigate outcomes of patients denied total hip (THA) or knee arthroplasty (TKA) due to morbid obesity. Methods: We performed an observational study of patients denied arthroplasty due to morbid obesity. A survey including the Harris Hip Score or pain and function components of the original Knee Society Score (KSS) was conducted with minimum 2-year follow-up. Statistical analysis was performed with parametric testing with significance at P < .05. Results: In total, 125 (4.4%) of 2819 patients were denied THA or TKA due to morbid obesity. Twenty-four (19.2%) met target weight and underwent arthroplasty at our institution. Of the remaining 101 (80.8%) patients, 33 (32.7%) agreed to participate in the survey. None received THA and 6 received TKA elsewhere above target body mass index. Harris Hip Score was significantly higher in the successful weight loss cohort at our institution (70.5 ± 13.4 vs 34.6 ± 13.1). KSS Pain (maximum score of 50) and Function (maximum score of 100) were significantly higher in the successful weight loss cohort at our institution (32.9 ± 16.5; 51.1 ± 19.5) compared to the denied nonoperative cohort (7.2 ± 11.5; 33.0 ± 23.1); however, only KSS Pain was higher when compared to the TKA elsewhere cohort (14.2 ± 18.0; 29.2 ± 38.7). KSS Pain and Function were similar for both denial cohorts regardless of undergoing arthroplasty. Conclusion: Nearly 80% of patients denied never met target weight for arthroplasty. Those who met target weight prior to arthroplasty often reported better outcomes. Outcomes were similar when target weight was not met regardless of undergoing arthroplasty.

show abstract

“…The prevalence of obesity continues to rise in parallel with the demand for total hip arthroplasty (Pirruccio et al, 2019). A relationship between surgical site infection (SSI) and morbid obesity or diabetes has consistently been reported; although both conditions are often concurrent, both diabetes and morbid obesity independently contribute to SSI risk.…”

Section: Discussionmentioning

confidence: 99%

Soft-tissue thickness radiographic measurement: a marker to evaluate acute periprosthetic joint infection risk in total hip replacement

Fernández

Crespo

Álvarez

et al. 2021

J. Bone Joint Infect.

View full text Add to dashboard Cite

Abstract. The objective of our study was to evaluate the association between acute periprosthetic joint infection (APJI) and radiographic measurement of soft-tissue thickness in elective total hip replacement surgery. A case-control study was conducted to compare the soft-tissue thickness radiographic measurement (SRM) at the hip in patients diagnosed with APJI based on Tsukayama et al. (2003) criteria after total hip replacement with patients that were not infected, at a single institution from 2013 to 2019. To minimize selection bias, each case was matched with two controls using the following methodology: patients of the same sex, with an age variation of ± 5 years, and nearest in surgery date to the cases were selected. All postoperative radiographs were performed in the first 24 h after total hip arthroplasty (THA) surgery as it is protocolized in our institution. Soft-tissue thickness radiographic measurement was defined as the distance from the tip of the greater trochanter to the skin following a perpendicular line to the femoral diaphysis in postoperative anteroposterior hip radiographs. In total, 78 patients were included (26 cases and 52 controls). The SRM median of the cases was 76.19 mm (SD: 26.518) and 53.5 mm (SD: 20.47) in controls. A multivariate logistic regression model showed an independent association between APJI and SRM (odds ratio (OR) = 1.033, 95 % confidence interval (CI) 1.007–1.059, p=0.012). Patients with an SRM greater than 60 mm had a 7-fold increase in the odds of APJI (OR = 7.295, 95 % CI = 2.364–22.511, p<0.001). The results of our study suggest an association between large SRM at the hip and the risk of APJI in patients with primary total hip arthroplasty. SRM may be a helpful and easy tool for evaluating the risk of APJI before elective primary total hip replacement surgery.

show abstract

Trends in obesity prevalence among total hip arthroplasty patients and the effect on surgical outcomes, 2008–2016

Cited by 21 publications

References 22 publications

Greater risks of complications, infections, and revisions in the obese versus non-obese total hip arthroplasty population of 2,190,824 patients: a meta-analysis and systematic review

Greater risks of complications, infections, and revisions in the obese versus non-obese total hip arthroplasty population of 2,190,824 patients: a meta-analysis and systematic review

Fate of the Morbidly Obese Patient Who Is Denied Total Joint Arthroplasty

Soft-tissue thickness radiographic measurement: a marker to evaluate acute periprosthetic joint infection risk in total hip replacement

Contact Info

Product

Resources

About