Joris Bongers1, Katrijn Smulders2, Marc W Nijhof1. 1. Department of Orthopaedics, Sint Maartenskliniek Nijmegen, Ubbergen, The Netherlands. 2. Department of Research, Sint Maartenskliniek Nijmegen, Ubbergen, The Netherlands. Electronic address: k.smulders@maartenskliniek.nl.
Abstract
BACKGROUND: The increasing prevalence of obesity has resulted in an increased number of revision total hip arthroplasties (rTHAs) performed in patients with a high body mass index (BMI). The aim of this study is to evaluate whether obesity negatively affects (1) complication rate, (2) reoperation and revision rate, and (3) patient-reported outcome in rTHA. METHODS: In this registry-based study, we prospectively followed 444 rTHAs (cup: n = 265, stem: n = 57, both: n = 122) performed in a specialized high-volume orthopedic center between 2013 and 2015. The number of complications, and reoperation and revision surgery was registered until 5 years postoperatively. Oxford Hip Score (OHS) was evaluated preoperatively, and at 1 and 2 years postoperatively. Patients were categorized based on BMI to nonobese (<30 kg/m2, n = 328), obese (30-35 kg/m2, n = 82), and severe obese (≥35 kg/m2, n = 34). RESULTS: Severe obese patients, but not obese patients, had higher risks of complications and re-revision than nonobese patients. In particular, the risk of infection following rTHA was higher in severe obese patients (24%) compared to nonobese patients (3%; relative risk, 7.7). Severe obese patients had overall poorer OHS than nonobese patients, but improvement in OHS did not differ between severe obese and nonobese patients. No differences between obese and nonobese groups on OHS were observed. CONCLUSION: In our study, severe obesity was associated with an increased risk of infection following rTHA. Patients with high BMI should be counseled appropriately before surgery.
BACKGROUND: The increasing prevalence of obesity has resulted in an increased number of revision total hip arthroplasties (rTHAs) performed in patients with a high body mass index (BMI). The aim of this study is to evaluate whether obesity negatively affects (1) complication rate, (2) reoperation and revision rate, and (3) patient-reported outcome in rTHA. METHODS: In this registry-based study, we prospectively followed 444 rTHAs (cup: n = 265, stem: n = 57, both: n = 122) performed in a specialized high-volume orthopedic center between 2013 and 2015. The number of complications, and reoperation and revision surgery was registered until 5 years postoperatively. Oxford Hip Score (OHS) was evaluated preoperatively, and at 1 and 2 years postoperatively. Patients were categorized based on BMI to nonobese (<30 kg/m2, n = 328), obese (30-35 kg/m2, n = 82), and severe obese (≥35 kg/m2, n = 34). RESULTS: Severe obesepatients, but not obesepatients, had higher risks of complications and re-revision than nonobese patients. In particular, the risk of infection following rTHA was higher in severe obesepatients (24%) compared to nonobese patients (3%; relative risk, 7.7). Severe obesepatients had overall poorer OHS than nonobese patients, but improvement in OHS did not differ between severe obese and nonobese patients. No differences between obese and nonobese groups on OHS were observed. CONCLUSION: In our study, severe obesity was associated with an increased risk of infection following rTHA. Patients with high BMI should be counseled appropriately before surgery.
Authors: Inaya Hajj Hussein; Abdul Kareem Zalikha; Zachary Crespi; Andrei Tuluca; Avianna E Arapovic; Mouhanad M El-Othmani Journal: J Am Acad Orthop Surg Glob Res Rev Date: 2022-08-05