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Total Hip Arthroplasty in Morbidly Obese: Does a Strict Body Mass Index Cutoff Yield Meaningful Change?

Publication ,  Journal Article
Cochrane, N; Ryan, S; Kim, B; Wu, M; O'Donnell, J; Seyler, T
Published in: Hip Pelvis
September 2022

PURPOSE: The number of obese patients seeking total hip arthroplasty (THA) continues to expand despite body mass index (BMI) cutoffs. We sought to determine the outcomes of THA in the morbidly obese patient, and hypothesized they would have comparable outcomes to two cohorts of obese, and normal weight patients. MATERIALS AND METHODS: THA performed on morbidly obese patients (BMI >40 kg/m2) at a single academic center from 2010 until 2020 were retrospectively reviewed. Eighty morbidly obese patients were identified, and matched in a 1:3:3 ratio to control cohorts with BMI 30-40 kg/m2 and BMI <30 kg/m2. Acute postoperative outcomes and BMI change after surgery were evaluated for clinical significance with univariate and regression analyses. Cox proportional hazard ratio was calculated to evaluate prosthetic joint infection (PJI) and revision surgery through follow-up. Mean follow-up was 3.9 years. RESULTS: In the acute postoperative period, morbidly obese patients trended towards increased hospital length of stay, facility discharge and 90-day hospital returns. At final follow-up, a higher percentage of morbidly obese patients had clinically significant (>5%) BMI loss; however, this was not significant. Cox hazard ratio with BMI <30 kg/m2 as a reference demonstrated no significant difference in survival to PJI and all-cause revision in the morbidly obese cohort. CONCLUSION: Morbidly obese patients (BMI >40 kg/m2) require increased resource expenditure in the acute postoperative period. However, they are not inferior to the control cohorts (BMI <30 kg/m2, BMI 30-40 kg/m2) in terms of PJI or all-cause revisions at mid-term follow-up.

Duke Scholars

Published In

Hip Pelvis

DOI

ISSN

2287-3260

Publication Date

September 2022

Volume

34

Issue

3

Start / End Page

161 / 171

Location

Korea (South)
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Cochrane, N., Ryan, S., Kim, B., Wu, M., O’Donnell, J., & Seyler, T. (2022). Total Hip Arthroplasty in Morbidly Obese: Does a Strict Body Mass Index Cutoff Yield Meaningful Change? Hip Pelvis, 34(3), 161–171. https://doi.org/10.5371/hp.2022.34.3.161
Cochrane, Niall, Sean Ryan, Billy Kim, Mark Wu, Jeffrey O’Donnell, and Thorsten Seyler. “Total Hip Arthroplasty in Morbidly Obese: Does a Strict Body Mass Index Cutoff Yield Meaningful Change?Hip Pelvis 34, no. 3 (September 2022): 161–71. https://doi.org/10.5371/hp.2022.34.3.161.
Cochrane N, Ryan S, Kim B, Wu M, O’Donnell J, Seyler T. Total Hip Arthroplasty in Morbidly Obese: Does a Strict Body Mass Index Cutoff Yield Meaningful Change? Hip Pelvis. 2022 Sep;34(3):161–71.
Cochrane, Niall, et al. “Total Hip Arthroplasty in Morbidly Obese: Does a Strict Body Mass Index Cutoff Yield Meaningful Change?Hip Pelvis, vol. 34, no. 3, Sept. 2022, pp. 161–71. Pubmed, doi:10.5371/hp.2022.34.3.161.
Cochrane N, Ryan S, Kim B, Wu M, O’Donnell J, Seyler T. Total Hip Arthroplasty in Morbidly Obese: Does a Strict Body Mass Index Cutoff Yield Meaningful Change? Hip Pelvis. 2022 Sep;34(3):161–171.

Published In

Hip Pelvis

DOI

ISSN

2287-3260

Publication Date

September 2022

Volume

34

Issue

3

Start / End Page

161 / 171

Location

Korea (South)