Obesity in total hip replacement.

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Clinical Outcomes Research

Background:

• Obesity is a growing public health concern.
• The impact of obesity on total hip replacement (THR) outcomes remains a subject of investigation.
• Understanding these effects is crucial for patient selection and surgical planning.

Purpose of the Study:

• To investigate the influence of obesity on clinical and radiological outcomes following total hip replacement.
• To compare outcomes across non-obese, obese, and morbidly obese patient groups.

Main Methods:

• Prospective, multi-centre study of 1421 total hip replacements (THRs).
• Patients categorized by body mass index (BMI): non-obese (<30 kg/m²), obese (30-40 kg/m²), and morbidly obese (>40 kg/m²).
• Primary outcome: change in Oxford hip score at 5 years. Secondary outcomes: complication rates (dislocation, infection, DVT, PE), operating time, hospital stay, and radiological changes.

Main Results:

• No significant differences in Oxford hip score changes, complication rates, or radiological outcomes at 5 years between BMI groups.
• Morbidly obese patients were younger and had longer operating times.
• Data were incomplete for 25.5% of hips.

Conclusions:

• Obesity, including morbid obesity, does not adversely affect the clinical or radiological outcomes of total hip replacement at five years.
• Obese and morbidly obese patients derive comparable benefits from THR as non-obese patients.
• While operating times may be longer in the morbidly obese, the overall benefits of THR are similar across BMI categories.