Background: Total hip arthroplasty (THA) is one of the most performed orthopaedic procedures commonly used for the treatment of osteoarthritis (OA). There are several underlying factors that lead to the formation of this condition. Not only is obesity one of the main contributors, but it is also a modifiable risk factor and one of the leading causes of end-stage arthrosis of the hip. Though there have been advancements in agricultural and health technologies, rates of obesity continue to rise causing similar increases in the demands for hip replacement surgeries. Therefore, we sought to investigate the effects of BMI on THA procedures and determine if it plays any influential role in patient characteristics, operative planning, and postoperative outcomes.
Methods: A prospectively collected database from a single institution was queried from January 2018 to December 2021, to identify 66 THA patients (mean age 69.5) included in this study. Patient’s BMI were recorded preoperatively and separated into five classes in accordance with the World Health Organization classification of Normal (18.5-24.9), Pre-Obesity (25.0-29.9), Obesity Class I (30.0-34.9), Obesity Class II (35.0-39.9), and Obesity Class III (BMI ≥ 40). Patient attributes, operative characteristics, and postoperative outcomes were then stratified and grouped into the different BMI classes. All patients had radiograph imaging obtained preoperatively and at a minimum 9-month interval to observe for the presence of any radiolucent lines which would be plotted using the hip regions set forth by De Lee and Charnley.
Results: The mean BMI of our patient population was 30.5 which overall characterizes it as Obesity Class I. However, the classification that contained the most of our population was Pre-Obesity (n = 26, 39.4%). There were no males in our entire population that had a BMI considered normal, but 13 females did fall into this classification. There was a significant number of patients who underwent a direct anterior approach within the Pre-Obesity classification than those who underwent a posterolateral approach (21 vs 5 patients, P value = 0.047). However, for subjects meeting Obesity Class II and Class III criteria, a significant number of posterolateral approaches were performed than the direct anterior approach. In analyzing the radiographs, only 2 patients were discovered to have radiolucent lines, but no related symptoms or physical complications were reported.
Conclusion: Our investigation demonstrates that having a higher BMI only significantly affects the surgical approach to THA but can conclude that it is an excellent surgical option for the treatment of OA in obese patients.
Sevilla Jr, Cesar A.; Lopez, Vanessa Elena; Burbano, Mauricio; and Sander, Michael, "Analyzing the Effects of Body Mass Index in Total Hip Arthroplasty Cases. Does it Influence Patient Characteristics, Operative Planning, and Postoperative Outcomes?" (2023). MEDI 9331 Scholarly Activities Clinical Years. 72.