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General Orthopaedics

TOTAL HIP ARTHROPLASTY IN OBESE PATIENTS: AN UPDATED LITERATURE REVIEW

The International Society for Technology in Arthroplasty (ISTA), 27th Annual Congress. PART 2.



Abstract

Purpose

To update recent findings about the relationship between obesity and post-operative outcome including acetabular cup positioning, complications, readmissions and revision rates, and also inpatient rehabilitation outcome following total hip arthroplasty.

Methods

A literature review was done using standard keyword search. Articles were scrutinized by the investigators to ensure relevancy to the purpose of this review.

Summary of the review

As the number of all obese(body mass index(BMI) >30) are rising, the development of hip osteoarthritis and the need for total hip arthroplasty(THA) increased. Recent studies found that high BMI was the most significant risk factor contributed to acetabular cup malpositioning following THA. Obesity was found to be a predicting factor for 30-day readmission due to complications include wound infections and thromboembolism after THA. A meta-analysis had shown increased rates of aseptic loosening, dislocation and infection in obese patients thus resulted in higher revision rates compared to nonobese patients but the increase was not found to be statistically significant. Obese patients can make functional improvements during inpatient rehabilitation but at slow progress and higher cost.

Conclusion

Based on the current literature, obesity may have a negative impact on the outcome of THA. It appeared that as BMI increases, obesity was related with the risk of postoperative complications, and affected outcomes after total hip arthroplasty. Therefore, this needs to be informed to every patient prior to considering total hip arthroplasty.


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