October 2, 2014

Morbid Obesity and Hip Replacement

When it comes to hip replacement surgery does being what is termed ‘morbidly obese’ affect the outcome?
In a study of 3290 Total Hip Replacements in patients with osteoarthritis, orthopedists at a single Canadian center examined outcomes according to body mass index. Six per cent of the patients were considered to be morbidly obese, 37% were obese, 37% were overweight and 20% were considered to be normal or underweight.
When symptoms and function were assessed preoperatively the mean scores were worse in the morbidly obese group than in the other groups. However 1 -2 years’ post operative scores among patients in all weight categories improved and actually became similar. When it came to the need for revision surgery during a mean follow up of 8 years it was only slightly higher in the morbidly obese group at 5.3% versus 3.9% in the other groups combined.
So it would seem that from these findings denying Total Hip Replacement to the morbidly obese is not justified. Also, although the improvements in function were self reported in this instance and not assessed independently, it can still be said that a patient’s perception is equally valid.
McCalden RW et al. Does morbid obesity affect the outcome of total hip replacement? An analysis of 3290 THRs. J Bone Joint Surg Br 2011 Mar; 93-B:321. (http://dx.doi.org/10.1302/0301-620X.93B3.25876)

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