Weight Loss Before Total Hip Arthroplasty Was Not Associated with Decreased Postoperative Risks.

Area of Science:

• Orthopedic Surgery
• Obesity Medicine
• Health Outcomes Research

Background:

• Surgeons often use body mass index (BMI) cutoffs for total hip arthroplasty (THA) eligibility.
• Limited data exists on patient weight loss patterns and outcomes before THA.

Purpose of the Study:

• Determine the prevalence of preoperative weight loss in patients undergoing primary THA.
• Identify predictors of weight loss before THA.
• Evaluate the association between preoperative weight loss and THA outcomes.

Main Methods:

• Analysis of 53,038 primary THAs (2002-2019).
• Focused on 2,463 patients with BMI ≥30 kg/m², comparing weight 1-24 months pre-op to surgery.
• Used logistic regression and Cox models to assess weight change impact on outcomes (e.g., infection, revision).

Main Results:

• Only 12% of patients lost ≥20 pounds pre-THA; 28% with BMI ≥40 kg/m² reached <40 kg/m² (mean 1.3 years).
• No significant improvements observed in operative time, length of stay, or discharge disposition.
• No reduction in periprosthetic joint infection, complications, revision, or reoperation rates for any weight loss group.

Conclusions:

• Significant preoperative weight loss is infrequent before primary THA.
• Preoperative weight loss did not correlate with reduced complications or improved surgical outcomes.
• Current evidence questions the sole efficacy of preoperative weight loss for reducing THA complications.