DOES BODY MASS INDEX AFFECT THE EARLY OUTCOME OF TOTAL HIP REPLACEMENT?

Abstract

There is little evidence describing the influence of body mass index on the outcome of Total Hip Replacement (THR). There are concerns that an increasing BMI may lead to increased blood loss, infection and venous thromboembolism. 800 consecutive patients undergoing primary cemented THR were followed for a minimum of 18 months. The Harris Hip Score (HHS) and SF-36 were recorded pre-operatively and at 6 and 18 months post-operatively. In addition other significant events were noted, namely death, dislocation, re-operation, superficial and deep infection and blood loss. Multiple regression analysis was performed to identify whether BMI was an independently significant predictor of the outcome of THR.

No relationship was seen between the BMI of an individual and the development of any of the complications noted. The HHS was seen to increase dramatically post-operatively in all patients. BMI did predict for a lower HHS at 6 and 18 months, and a lower physical functioning component of the SF-36 at 18 months. This effect was small when compared with the overall improvements in these scores.

Conclusion: THR provides good symptomatic relief irrespective of BMI. On the basis of this study we can find no justification for withholding THR solely on the grounds of BMI.