Abstract
Introduction: With the rising number of primary hip arthroplasties performed each year, patient selection criteria is becoming increasingly pertinent. There is growing concern that patients with a high body mass index (BMI) have worse outcomes following hip replacement surgery. However the evidence base is equivocal.
Our aim is to assess whether BMI has an impact on clinical and radiological outcomes of primary total hip arthroplasties
Methods: This is a prospective study of 92 patients, undergoing primary total hip arthroplasty, recruited from two hospitals. Data was collected by the operating surgical team and independent physiotherapists at the preoperative assessment clinic, intraoperatively and at six weeks post-operative follow up.
BMI was recorded. Patients were divided into 2 groups: those with a BMI less than 30 (considered nonobese) and those 30 or above (obese).
Outcomes assessed included blood loss and requirement blood transfusion, fat thickness, operation duration, complications and surgeon’s perception of the difficulty of operation (scored on a VAS). In addition functional capacity was assessed using the Oxford Hip scores pre and post-operatively. Radiographs were scored independently according to Dorr and Barrack.
Results: Of our 92 patients, 36 were obese and 56 were non-obese. There was no significant difference found in blood loss, blood transfusion requirements, operation duration and complications between the two groups, With regards to the Oxford Hip scores, the obese patients had greater differences between their pre- and post-operative scores but this difference was not significant (p=0.09). We found a significant difference (p=0.003) in surgeons’ perception of the difficulty of operation with VAS scores for obese patients being higher than non-obese patients. Our Dorr and Barrack scores revealed no significant difference in radiological outcome between our two groups.
Conclusion: Our study would suggest that obese patients do not have worse outcomes following primary total hip arthroplasty than non-obese patients.
Correspondence should be addressed to Mr John Hodgkinson, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
