Complications of Total Hip Arthroplasty in Obese Patients: A Systematic Review

Total hip arthroplasty (THA) is a widely preferred surgical intervention for patients with severe hip osteoarthritis, as it significantly improves mobility and quality of life. The aim of this review is to evaluate the literature on the prevalence and frequency of common complications associated with THA in obese patients.

This systematic review identified relevant studies through searches of electronic databases, including PubMed and the Cochrane Library. The search was conducted for studies published between 2005 and 2024, employing a combination of keywords such as "arthroplasty," "hip," "osteoarthritis," "complication," and "obese." Boolean operators ("OR" and "AND") were utilized to refine and optimize the search strategy. The study endpoints included the complication rates and their common types in obese THA patients.

A total of 481 studies were initially identified, with 424 deemed relevant during the preliminary search. After screening titles and abstracts, 411 studies were excluded, leaving 13 eligible papers for inclusion and analysis. The total patient population across these studies was 1,676,926, of whom 241,920 were classified as obese. Approximately 340,328 were male and 437,652 were female, with a mean age of 60.6 years. Among the 241,920 obese patients, 32,556 complications were reported, corresponding to a prevalence of 13.5%. The most common complications included readmission (21.6%), revision surgery (14.2%), infections (11.4%), thrombosis/embolism (7.8%), dislocation (5.2%), nerve complications (2.2%), and fractures (0.02%). Additionally, 37.6% of the complications fell into the category of other or unspecified.

This review demonstrates that the complication rate in THA is 13.5%, affirming that it remains a safe, effective, and viable treatment option for obese patients with hip joint pathology. However, the higher rates of readmissions, revision surgeries, and infections underscore the need for careful patient selection and tailored perioperative strategies. A multidisciplinary approach, combined with ongoing research, could optimize outcomes in this high-risk patient population.