Skip to main content
Top
Published in: Obesity Surgery 5/2008

01-05-2008 | Research Article

Influence of High BMI on Functional Outcome After Total Hip Arthroplasty

Authors: André Busato, Christoph Röder, Sylvia Herren, Stefan Eggli

Published in: Obesity Surgery | Issue 5/2008

Login to get access

Abstract

Background

High body mass index (BMI) is associated with diseases of the hip joint and subsequent total hip arthroplasty (THA). Less is known about the effects of BMI on the functional postoperative status after THA in obese patients. The purpose of this study was therefore to quantify the role of high preoperative BMI on long-term pain status and functional outcome after THA.

Methods

In a multi-center cohort, study data of 20,553 primary THAs (18,968 patients) and 43,562 postoperative clinical examinations were analyzed for a follow-up period of up to 15 years. Patients were classified into three BMI groups (normal weight <25 kg/m2, overweight 25 to <30 kg/m2, and obese ≥30 kg/m2), and pain status and functional outcome were compared accordingly.

Results

High preoperative BMI is associated to an almost perfect dose–effect relationship with decreased ambulation during a follow-up period of 15 years, but pain relief of THA is equally efficient for all BMI groups.

Conclusion

Overweight and obesity are modifiable risk factors that may warrant physicians giving recommendations to patients before or after THA, to improve postoperative functional outcome quality.
Literature
1.
go back to reference Flugsrud GB, Nordsletten L, Espehaug B, et al. The impact of body mass index on later total hip arthroplasty for primary osteoarthritis: a cohort study in 1.2 million persons. Arthritis Rheum. 2006;54(3):802–7.PubMedCrossRef Flugsrud GB, Nordsletten L, Espehaug B, et al. The impact of body mass index on later total hip arthroplasty for primary osteoarthritis: a cohort study in 1.2 million persons. Arthritis Rheum. 2006;54(3):802–7.PubMedCrossRef
2.
go back to reference Perka C, Paul C, Matziolis G. Factors influencing perioperative morbidity and mortality in primary hip arthroplasty. Orthopäde. 2004;33(6):715–20.PubMedCrossRef Perka C, Paul C, Matziolis G. Factors influencing perioperative morbidity and mortality in primary hip arthroplasty. Orthopäde. 2004;33(6):715–20.PubMedCrossRef
3.
go back to reference Braeken AM, Lochhaas-Gerlach JA, Gollish JD, et al. Determinants of 6–12 month postoperative functional status and pain after elective total hip replacement. Int J Qual Health Care. 1997;9(6):413–8.PubMedCrossRef Braeken AM, Lochhaas-Gerlach JA, Gollish JD, et al. Determinants of 6–12 month postoperative functional status and pain after elective total hip replacement. Int J Qual Health Care. 1997;9(6):413–8.PubMedCrossRef
4.
go back to reference Young NL, Cheah D, Waddell JP, et al. Patient characteristics that affect the outcome of total hip arthroplasty: a review. Can J Surg. 1998;41(3):188–95.PubMed Young NL, Cheah D, Waddell JP, et al. Patient characteristics that affect the outcome of total hip arthroplasty: a review. Can J Surg. 1998;41(3):188–95.PubMed
5.
go back to reference Stickles B, Phillips L, Brox WT, et al. Defining the relationship between obesity and total joint arthroplasty. Obes Res. 2001;9(3):219–23.PubMedCrossRef Stickles B, Phillips L, Brox WT, et al. Defining the relationship between obesity and total joint arthroplasty. Obes Res. 2001;9(3):219–23.PubMedCrossRef
6.
go back to reference Paterson D. The International Documentation and Evaluation System (IDES). Orthopedics. 1993;16(1):11–4.PubMed Paterson D. The International Documentation and Evaluation System (IDES). Orthopedics. 1993;16(1):11–4.PubMed
7.
go back to reference Wendelboe AM, Hegmann KT, Biggs JJ, et al. Relationships between body mass indices and surgical replacements of knee and hip joints. Am J Prev Med. 2003;25(4):290–5.PubMedCrossRef Wendelboe AM, Hegmann KT, Biggs JJ, et al. Relationships between body mass indices and surgical replacements of knee and hip joints. Am J Prev Med. 2003;25(4):290–5.PubMedCrossRef
8.
go back to reference Karlson EW, Mandl LA, Aweh GN, et al. Total hip replacement due to osteoarthritis: the importance of age, obesity, and other modifiable risk factors. Am J Med. 2003;114(2):93–8.PubMedCrossRef Karlson EW, Mandl LA, Aweh GN, et al. Total hip replacement due to osteoarthritis: the importance of age, obesity, and other modifiable risk factors. Am J Med. 2003;114(2):93–8.PubMedCrossRef
9.
go back to reference Gelber AC. Obesity and hip osteoarthritis: the weight of the evidence is increasing. Am J Med. 2003;114(2):158–9.PubMedCrossRef Gelber AC. Obesity and hip osteoarthritis: the weight of the evidence is increasing. Am J Med. 2003;114(2):158–9.PubMedCrossRef
10.
go back to reference Marks R, Allegrante JP. Body mass indices in patients with disabling hip osteoarthritis. Arthritis Res. 2002;4(2):112–6.PubMedCrossRef Marks R, Allegrante JP. Body mass indices in patients with disabling hip osteoarthritis. Arthritis Res. 2002;4(2):112–6.PubMedCrossRef
11.
go back to reference Sturmer T, Gunther KP, Brenner H. Obesity, overweight and patterns of osteoarthritis: the Ulm Osteoarthritis Study. J Clin Epidemioly. 2000;53(3):307–13.CrossRef Sturmer T, Gunther KP, Brenner H. Obesity, overweight and patterns of osteoarthritis: the Ulm Osteoarthritis Study. J Clin Epidemioly. 2000;53(3):307–13.CrossRef
12.
go back to reference Perka C, Labs K, Muschik M, et al. The influence of obesity on perioperative morbidity and mortality in revision total hip arthroplasty. Arch Orthop Trauma Surg. 2000;120(5–6):267–71.PubMedCrossRef Perka C, Labs K, Muschik M, et al. The influence of obesity on perioperative morbidity and mortality in revision total hip arthroplasty. Arch Orthop Trauma Surg. 2000;120(5–6):267–71.PubMedCrossRef
13.
go back to reference Kenchaiah S, Evans JC, Levy D, et al. Obesity and the risk of heart failure. N Engl J Med. 2002;347(5):305–13.PubMedCrossRef Kenchaiah S, Evans JC, Levy D, et al. Obesity and the risk of heart failure. N Engl J Med. 2002;347(5):305–13.PubMedCrossRef
14.
go back to reference Calle EE, Rodriguez C, Walker-Thurmond K, et al. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348(17):1625–38.PubMedCrossRef Calle EE, Rodriguez C, Walker-Thurmond K, et al. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348(17):1625–38.PubMedCrossRef
15.
go back to reference March LM, Cross MJ, Lapsley H, et al. Outcomes after hip or knee replacement surgery for osteoarthritis. A prospective cohort study comparing patients’ quality of life before and after surgery with age-related population norms. Med J Aust. 1999;171(5):235–8.PubMed March LM, Cross MJ, Lapsley H, et al. Outcomes after hip or knee replacement surgery for osteoarthritis. A prospective cohort study comparing patients’ quality of life before and after surgery with age-related population norms. Med J Aust. 1999;171(5):235–8.PubMed
16.
go back to reference Cooper C, Inskip H, Croft P, et al. Individual risk factors for hip osteoarthritis: obesity, hip injury, and physical activity. Am J Epidemiol. 1998;147(6):516–22.PubMed Cooper C, Inskip H, Croft P, et al. Individual risk factors for hip osteoarthritis: obesity, hip injury, and physical activity. Am J Epidemiol. 1998;147(6):516–22.PubMed
17.
go back to reference Taylor BC, Schreiner PJ, Stone KL, et al. Long-term prediction of incident hip fracture risk in elderly white women: study of osteoporotic fractures. J Am Geriatr Soc. 2004;52(9):1479–86.PubMedCrossRef Taylor BC, Schreiner PJ, Stone KL, et al. Long-term prediction of incident hip fracture risk in elderly white women: study of osteoporotic fractures. J Am Geriatr Soc. 2004;52(9):1479–86.PubMedCrossRef
18.
go back to reference McLaughlin JR, Lee KR. The outcome of total hip replacement in obese and non-obese patients at 10- to 18-years. J Bone Joint Surg Br. 2006;88(10):1286–92.PubMedCrossRef McLaughlin JR, Lee KR. The outcome of total hip replacement in obese and non-obese patients at 10- to 18-years. J Bone Joint Surg Br. 2006;88(10):1286–92.PubMedCrossRef
19.
go back to reference Parvizi J, Trousdale RT, Sarr MG. Total joint arthroplasty in patients surgically treated for morbid obesity. J Arthroplasty. 2000;15(8):1003–8.PubMedCrossRef Parvizi J, Trousdale RT, Sarr MG. Total joint arthroplasty in patients surgically treated for morbid obesity. J Arthroplasty. 2000;15(8):1003–8.PubMedCrossRef
20.
go back to reference Mantilla CB, Horlocker TT, Schroeder DR, et al. Risk factors for clinically relevant pulmonary embolism and deep venous thrombosis in patients undergoing primary hip or knee arthroplasty. Anesthesiology. 2003;99(3):552–60; discussion 5A.PubMedCrossRef Mantilla CB, Horlocker TT, Schroeder DR, et al. Risk factors for clinically relevant pulmonary embolism and deep venous thrombosis in patients undergoing primary hip or knee arthroplasty. Anesthesiology. 2003;99(3):552–60; discussion 5A.PubMedCrossRef
Metadata
Title
Influence of High BMI on Functional Outcome After Total Hip Arthroplasty
Authors
André Busato
Christoph Röder
Sylvia Herren
Stefan Eggli
Publication date
01-05-2008
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 5/2008
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-007-9412-8

Other articles of this Issue 5/2008

Obesity Surgery 5/2008 Go to the issue