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Obesity increases complication risk after revision THA, study finds

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SAN FRANCISCO — Obese patients who undergo revision total hip arthroplasty have a significantly increased risk for complications, particularly infection and dislocation, according to a prospective study presented here.

Anne Lübbeke, MD, DSc, and colleagues at Geneva University Hospital, Switzerland, and at University Medical Center in Utrechet, The Netherlands, investigated the influence of obesity on the functional outcomes and complication rates of revision total hip arthroplasty (THA). They displayed their results in a poster at the American Academy of Orthopaedic Surgeons 75th Annual Meeting.

The study included 204 consecutive patients who averaged 71.6 years of age. The group had an overall average 26.7 body mass index (BMI).

Surgeons performed 52 revisions (25%) on obese patients who had a BMI of 30 or higher, which included 11 highly obese patients with a BMI of 35 or higher, according to the study.

Regarding complications, follow-up ranged from 3 months to 74 months.

The researchers identified six infections (11.5%) among obese patients, including three superficial and three deep infections. In comparison, there were four cases of infection among non-obese patients (2.6%), which included one superficial and three deep infections.

There was also a 19.2% dislocation rate among obese patients compared to a 6.6% dislocation rate among non-obese patients.

Four obese patients (7.7%) and four non-obese patients (2.6%) also required re-revision, according to the study.

Among 80 patients with 5 years follow-up, the researchers found that obese patients had moderately lower functional results, with a mean Harris Hip Score (HHS) of 71 points vs. 83 points for non-obese patients.

Obese patients also had more pain, with a mean HHS pain score of 34 points compared to a mean HHS pain score of 39 points for non-obese patients, according to the study.

However, "satisfaction was almost similar," the study authors noted.

For more information:

• Lübbeke A, Moons C, Garavaglia G, Hoffmeyer P. Outcomes of obese and non-obese patients undergoing revision total hip arthroplasty. Poster P059. Presented at the American Academy of Orthopaedic Surgeons 75th Annual Meeting. March 5-9, 2008. San Francisco.