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Total hip arthroplasty outcomes in morbidly obese patients: A systematic review

Matthew Barrett1, Anoop Prasad2, Louis Boyce1

  • 1Barts and the London School of Medicine & Dentistry, UK.

EFORT Open Reviews
|October 12, 2018
PubMed

Insights

Morbidly obese patients undergoing total hip arthroplasty (THA) have a slightly higher revision rate but comparable functional outcomes to non-obese patients. Patients should be informed of these risks and benefits before surgery.

Area of Science:

  • Orthopedic Surgery
  • Obesity Medicine
  • Biostatistics

Background:

  • Rising obesity rates increase the number of total hip arthroplasties (THAs) performed on high body mass index (BMI) patients.
  • THA in morbidly obese individuals presents surgical challenges due to comorbidities and anatomical factors.
  • Long-term outcomes of THA in morbidly obese patients remain unclear.

Purpose of the Study:

  • To systematically review and compare the long-term failure rates and functional outcomes of THA in morbidly obese versus non-obese patients.
  • To assess the impact of high BMI on revision rates and patient function after THA.

Main Methods:

  • A systematic literature search was conducted on PubMed, EMBASE, and PubMed Central.
  • Studies comparing THA outcomes in morbidly obese patients (BMI ≥ 35) to controls (BMI < 30) were included.
  • Primary outcome: long-term revision rate; Secondary outcome: long-term functional outcome.

Main Results:

  • Eight studies involving 66,238 THAs in morbidly obese patients and 705,619 in non-obese patients were analyzed.
  • The overall revision rate was 7.99% in morbidly obese patients compared to 2.75% in non-obese controls.
  • Functional outcomes were comparable between morbidly obese and non-obese patient groups.

Conclusions:

  • Morbidly obese patients experience a slightly elevated revision rate after THA.
  • Despite increased revision risk, functional recovery in morbidly obese patients is comparable to non-obese individuals.
  • Informed consent regarding these specific outcomes is crucial for morbidly obese patients considering THA.

Keywords:
THAmorbidly obeseoutcomes

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