Abstract
Background
High body mass index (BMI) is associated with diseases of the hip joint and subsequent total hip arthroplasty (THA). Less is known about the effects of BMI on the functional postoperative status after THA in obese patients. The purpose of this study was therefore to quantify the role of high preoperative BMI on long-term pain status and functional outcome after THA.
Methods
In a multi-center cohort, study data of 20,553 primary THAs (18,968 patients) and 43,562 postoperative clinical examinations were analyzed for a follow-up period of up to 15 years. Patients were classified into three BMI groups (normal weight <25 kg/m2, overweight 25 to <30 kg/m2, and obese ≥30 kg/m2), and pain status and functional outcome were compared accordingly.
Results
High preoperative BMI is associated to an almost perfect dose–effect relationship with decreased ambulation during a follow-up period of 15 years, but pain relief of THA is equally efficient for all BMI groups.
Conclusion
Overweight and obesity are modifiable risk factors that may warrant physicians giving recommendations to patients before or after THA, to improve postoperative functional outcome quality.
Similar content being viewed by others
References
Flugsrud GB, Nordsletten L, Espehaug B, et al. The impact of body mass index on later total hip arthroplasty for primary osteoarthritis: a cohort study in 1.2 million persons. Arthritis Rheum. 2006;54(3):802–7.
Perka C, Paul C, Matziolis G. Factors influencing perioperative morbidity and mortality in primary hip arthroplasty. Orthopäde. 2004;33(6):715–20.
Braeken AM, Lochhaas-Gerlach JA, Gollish JD, et al. Determinants of 6–12 month postoperative functional status and pain after elective total hip replacement. Int J Qual Health Care. 1997;9(6):413–8.
Young NL, Cheah D, Waddell JP, et al. Patient characteristics that affect the outcome of total hip arthroplasty: a review. Can J Surg. 1998;41(3):188–95.
Stickles B, Phillips L, Brox WT, et al. Defining the relationship between obesity and total joint arthroplasty. Obes Res. 2001;9(3):219–23.
Paterson D. The International Documentation and Evaluation System (IDES). Orthopedics. 1993;16(1):11–4.
Wendelboe AM, Hegmann KT, Biggs JJ, et al. Relationships between body mass indices and surgical replacements of knee and hip joints. Am J Prev Med. 2003;25(4):290–5.
Karlson EW, Mandl LA, Aweh GN, et al. Total hip replacement due to osteoarthritis: the importance of age, obesity, and other modifiable risk factors. Am J Med. 2003;114(2):93–8.
Gelber AC. Obesity and hip osteoarthritis: the weight of the evidence is increasing. Am J Med. 2003;114(2):158–9.
Marks R, Allegrante JP. Body mass indices in patients with disabling hip osteoarthritis. Arthritis Res. 2002;4(2):112–6.
Sturmer T, Gunther KP, Brenner H. Obesity, overweight and patterns of osteoarthritis: the Ulm Osteoarthritis Study. J Clin Epidemioly. 2000;53(3):307–13.
Perka C, Labs K, Muschik M, et al. The influence of obesity on perioperative morbidity and mortality in revision total hip arthroplasty. Arch Orthop Trauma Surg. 2000;120(5–6):267–71.
Kenchaiah S, Evans JC, Levy D, et al. Obesity and the risk of heart failure. N Engl J Med. 2002;347(5):305–13.
Calle EE, Rodriguez C, Walker-Thurmond K, et al. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348(17):1625–38.
March LM, Cross MJ, Lapsley H, et al. Outcomes after hip or knee replacement surgery for osteoarthritis. A prospective cohort study comparing patients’ quality of life before and after surgery with age-related population norms. Med J Aust. 1999;171(5):235–8.
Cooper C, Inskip H, Croft P, et al. Individual risk factors for hip osteoarthritis: obesity, hip injury, and physical activity. Am J Epidemiol. 1998;147(6):516–22.
Taylor BC, Schreiner PJ, Stone KL, et al. Long-term prediction of incident hip fracture risk in elderly white women: study of osteoporotic fractures. J Am Geriatr Soc. 2004;52(9):1479–86.
McLaughlin JR, Lee KR. The outcome of total hip replacement in obese and non-obese patients at 10- to 18-years. J Bone Joint Surg Br. 2006;88(10):1286–92.
Parvizi J, Trousdale RT, Sarr MG. Total joint arthroplasty in patients surgically treated for morbid obesity. J Arthroplasty. 2000;15(8):1003–8.
Mantilla CB, Horlocker TT, Schroeder DR, et al. Risk factors for clinically relevant pulmonary embolism and deep venous thrombosis in patients undergoing primary hip or knee arthroplasty. Anesthesiology. 2003;99(3):552–60; discussion 5A.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Busato, A., Röder, C., Herren, S. et al. Influence of High BMI on Functional Outcome After Total Hip Arthroplasty. OBES SURG 18, 595–600 (2008). https://doi.org/10.1007/s11695-007-9412-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11695-007-9412-8