BMI and its association with patient-reported outcome measures following revision hip surgery

Obesity is associated with increased surgical complexity and poorer postoperative outcomes after primary total hip arthroplasty (THA), yet its impact on revision THA remains unclear. This study evaluates the relationship between BMI and outcomes following revision THA.

We analyzed prospectively collected data from patients who consented to participation in the Perioperative Quality Improvement Programme (PQIP) research study. All patients undergoing revision THA from May 2018 to December 2022 were included. Patients were stratified into BMI categories, and outcomes were assessed using the EuroQol five-dimension five-level questionnaire (EQ-5D-5L) at baseline, six, and 12 months postoperatively. Statistical comparisons were performed to evaluate differences in health-related quality of life (HRQoL) between BMI groups.

Higher BMI was associated with lower preoperative EQ-5D scores. However, all BMI groups demonstrated significant postoperative improvement, with the greatest gains observed in patients with a BMI > 40 kg/m². At six and 12 months, HRQoL improvements were comparable across BMI groups, with no significant difference in long-term outcomes between those living with and without obesity.

Despite potentially increased intraoperative risks, high BMI patients experience meaningful functional improvement following revision THA. These findings challenge the rationale for BMI-based surgical restrictions, suggesting that high BMI alone should not be a contraindication for revision THA.