Morbidly Obese vs Nonobese Aseptic Revision Total Hip Arthroplasty: Surprisingly Similar Outcomes
Chad D Watts1, Matthew T Houdek1, Eric R Wagner1
1Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Insights
Morbidly obese patients undergoing revision total hip arthroplasty (THA) had similar complication rates but higher dislocation risk. However, they experienced less polyethylene wear and aseptic loosening compared to nonobese patients.
Area of Science:
- Orthopedic Surgery
- Obesity Medicine
- Biomaterials Science
Background:
- Revision total hip arthroplasty (THA) is a complex procedure.
- Obesity is a growing concern in orthopedic patient populations.
- Understanding outcomes in morbidly obese patients undergoing revision THA is crucial.
Purpose of the Study:
- To compare outcomes between matched morbidly obese (BMI ≥ 40 kg/m²) and nonobese (BMI <30 kg/m²) patients.
- To evaluate complication rates, reoperation, and re-revision in first-time aseptic revision THA.
- To identify specific risks and benefits associated with obesity in revision hip surgery.
Main Methods:
- Matched cohort study comparing 123 morbidly obese and 123 nonobese patients.
- Matching criteria included sex, age, and date of revision surgery.
- Minimum follow-up of 4 years for all participants.
Main Results:
- Overall complication, reoperation, and re-revision rates were similar between the morbidly obese and nonobese groups.
- Morbidly obese patients had a significantly higher risk of dislocation (OR, 3.3; P = .03).
- Morbidly obese patients showed a lower risk of polyethylene wear (OR, 0.1; P = .04) and aseptic loosening (OR, 0.3; P = .03).
Conclusions:
- Obesity does not significantly increase overall complication or re-revision rates in first-time revision THA.
- Specific risks like dislocation are higher in morbidly obese patients, while wear and loosening may be lower.
- Future research should explore quality outcome measures like hospital readmission.
Background:
We aimed to compare the outcomes between matched morbidly obese (BMI ≥ 40 kg/m(2)) and nonobese (BMI <30 kg/m(2)) patients undergoing first-time aseptic revision THA with at least 4 years of follow-up.
Methods:
Groups were matched 1:1 using sex, age, and date of revision surgery (123 patients in each group).
Results:
The overall incidence and risk of complication, reoperation, and re-revision were similar between groups. Morbidly obese patients were more likely to dislocate (odds ratio [OR], 3.3; P = .03), but were less likely to develop polyethylene wear (OR, 0.1; P = .04) and aseptic loosening (OR, 0.3; P = .03).
Conclusion:
Quality outcome measures such as hospital readmission were not addressed by this study and could be the basis for future studies.
Level Of Evidence:
level III, prognostic study.
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