Obesity a significant risk factor in complication rates following THA

Posted on the ORTHOSuperSite August 25, 2011

Researchers from the Netherlands have found that obesity has a definite and significant impact upon the short- and long-term results of total hip arthroplasty.

“The incidence of obesity is increasing, not only in the United States but also in Europe,” Daniel Haverkamp, MD, PhD, said at the 12th EFORT Congress 2011. “Obesity is said to be a major risk factor for developing osteoarthritis, and if that is true we will see more obese in need of total hip arthroplasty (THA) in the coming years,” So I think it is important to know whether there is a higher complication rate in the obese, and if the long-term outcome is worse.”

Haverkamp and his team performed an analysis of studies that compared hip arthroplasty results across different weight groups, with methodology being scored according to the Cochrane guidelines. The researchers extracted and pooled the data, using a weighted mean difference for continuous data analysis and a weighted odds ratio for analysis of dichotomous variables.

“The results are really surprising,” Haverkamp said. “Three times higher infection rate. Two times higher dislocation rate. Aseptic loosening — 1.8 times higher in the long-term.”

The team identified 15 studies from which they could extract data. In 10 studies covering 8,634 patients they found that obese patients experienced dislocation more frequently. In 6 studies covering 5,137 patients, aseptic loosening was more common in obese patients. Infection and venous thromboembolism were also more common in obese patients across 10 studies with 7,500 patients and 7 studies with 3,716 patients, respectively.

Septic loosening and intraoperative fractures were found to be no different among obese patients, but Haverkamp noted this could possibly be attributed to low power.

Reference:

• Haverkamp D, Somford M, Klinkenbijl M, et al. Obesity in total hip arthroplasty, does it really matter? A meta-analysis. Paper #225. Presented at the 12th EFORT Congress 2011. June 1-4. Copenhagen, Denmark.

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