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No greater complication rate for obese patients following THR
Patients reported same rate of satisfaction as nonobese patients one year after surgery.
MANCHESTER,
England — Patient satisfaction rate was similar between obese and nonobese
patients at one year after total hip arthroplasty in a retrospective case
review reported here.
“In the short term, we found no differences between obese and nonobese patients with regards to patient satisfaction, intra- and postoperative complications, length of hospital stay and reoperation rates,” said T. Ibrahim, MD, University Hospital of Leicester, England, at the recent British Orthopaedic Association Annual Congress.
Investigators reviewed the body mass index of 162 patients who had total hip replacements during the year 2000, the patients’ length of stay during the hip replacement procedure and any intraoperative complications as recorded on the primary surgery questionnaire completed by the surgeon.
At one year, the patients responded to a questionnaire that asked about satisfaction with the surgery, the level of pain, types of complications and follow-up surgery.
Two groups matched
Patients were grouped by body mass index: normal or nonobese patients had a BMI of 18.5 to 24.9; obese patients, a BMI between 30 and 40. The two groups were roughly matched by age, sex, diagnosis, surgeons (whether a consulting surgeon or otherwise) and medical comorbidities.
Ibrahim said that on all measures there were no significant differences between the two groups. Length of stay was less than one week for about 50% of patients in both groups. There were seven intraoperative complications among the nonobese patients and four in the obese group.
Obese patients had slightly more wound problems postop, but overall the number of complications in both groups was not statistically significant, Ibrahim said. There were five revisions in both groups, but “surprisingly, the nonobese group had more revisions due to infection,” he said.
In a discussion period following the presentation of the paper, Ibrahim noted that the research did not quantify whether there was any worsening trend among the severely obese patients.
He said that the research period may have been too short (one-year follow-up) to detect a difference between the obese and nonobese patients. “What kind of implications does our study have and why did we have no serious differences between the groups?” he said.
Co-investigator R.A. Power, MD, also of Leicester, said that some surgeons currently tell their obese patients to lose weight prior to hip surgery; however, patients in their 60s and 70s who lose weight prior to surgery usually regain the weight quickly.
“The point of this paper is to demonstrate that the short-term complication rate was not significantly greater,” Power said.
For more information:
- Ibrahim T, Hobson S, Esler CAN, Power RA. Does body mass index influence patient satisfaction following total hip arthroplasty? Presented at the British Orthopaedic Association Annual Congress. Sept. 14-17, 2004. Manchester, England.