Clinical Impact of Obesity on Stability Following Revision Total Hip Arthroplasty

Kim, Youjeong; Morshed, Saam; Joseph, Tim; Bozic, Kevin J.; Ries, Michael D.

doi:10.1097/01.blo.0000238874.09390.a1

Cited by 78 publications

(51 citation statements)

References 23 publications

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“…In a recently published study on patients undergoing hip revision arthroplasty, the risk of implant dislocation was 6 times higher in obese patients than in non-obese patients (Kim et al 2006). These two results support the hypothesis that high BMI is an important risk factor for implant dislocation.…”

Section: Discussionsupporting

confidence: 76%

High body mass index is associated with increased risk of implant dislocation following primary total hip replacement: 2,106 patients followed for up to 8 years

et al. 2008

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Section: Discussionsupporting

confidence: 76%

High body mass index is associated with increased risk of implant dislocation following primary total hip replacement: 2,106 patients followed for up to 8 years

et al. 2008

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“…The authors also defined obesity as a BMI of greater than 35 kg/m 2 and nonobese as less than 30 kg/m 2 . Patients in between these two values were not included in the study [7]. Another study of 229 patients by Perka et al [13] reported overweight patients had an increased operative time in revision hip surgery but no other increase in perioperative complications.…”

Section: Discussionmentioning

confidence: 99%

“…This assumption is supported by the data of McClung et al [9] who quantified the daily activity level of 209 patients with a pedometer and found obese patients were less active. Kim et al [7] studied the outcomes of revision hip arthroplasties of nonobese versus obese patients. They reported obese patients were six times more likely to sustain dislocations than nonobese patients, and obese patients were two times more likely to undergo repeat revision surgery than nonobese patients.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Isolated Acetabular Revision

Lawless

Healy

Sharma

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Isolated acetabular revision can be associated with variable patient outcomes; there is a risk of hip instability. We evaluated 42 isolated acetabular revision operations and investigated the impact of patient age, diagnosis, bone stock, bone loss, bone augmentation, and obesity on pain and the Harris hip score. Preoperative radiographs were graded according to Paprosky et al. Postoperative radiographs were graded according to Moore et al. and for implant position, prosthetic fixation, and osteolysis. Complications, patient outcome, reoperations, and acetabular rerevisions were recorded. All patients had complete clinical and radiographic followup with a minimum followup of 2 years (mean, 6.4 years; range, 2-13 years). The mean pain score and the mean Harris hip score improved postoperatively. There was one infection 6 months after operation. There were no dislocations. There were three acetabular rerevisions (7%) for aseptic loosening. Patient age, preoperative diagnosis, bone loss, and pelvic bone augmentation had no influence on pain or Harris hip scores. Before operation, obese patients tended to have less pain than nonobese patients but at followup obese patients had less improvement in pain scores than nonobese patients.

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“…When obesity is defined as a body mass index (BMI) greater than 30 kg/m 2 in adults, obesity is recognized as an independent risk factor for postoperative hip dislocation in several studies [2,6,8,15,18,22,28,35]. However, in these patients with obesity, it is not known whether the risk is only in the early postoperative period or if the risk persists several years after surgery.…”

Section: Introductionmentioning

confidence: 99%

“…All yearly postsurgery weight outcomes were compared with the presurgery weight with the BMI index. Because thigh impingement is one cause of dislocation [14,18], and because we have noted that after bariatric surgery some patients had a decrease in BMI without resolution of thigh impingement, we also measured (Fig. 3) thigh circumference and hip circumference (Table 2), which are parameters [16,20,25] of the body adiposity index (BAI) [3], an alternative measure of body fat.…”

Section: Evaluation Of Obesitymentioning

confidence: 99%

Dual-mobility or Constrained Liners Are More Effective Than Preoperative Bariatric Surgery in Prevention of THA Dislocation

Hernigou

Trousselier

Roubineau

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Obesity is associated with an increased risk of dislocation after total hip arthroplasty (THA). However, in patients with obesity, it is not known whether the risk is only in the early postoperative period or whether it persists several years after surgery, and whether having bariatric surgery before undergoing THA and/or receiving a specific device (such as a dual-mobility or constrained acetabular liner) is more effective in terms of decreasing the risk of dislocation. Question/purposes (1) What is the cumulative risk of dislocation in patients with obesity after THA in the absence of a dual-mobility or constrained liner, and is this related to component positioning? (2) Does bariatric surgery before undergoing THA decrease dislocation risk in patients with obesity? (3) Are dual-mobility and constrained liners efficient in preventing dislocation in patients with obesity? Methods At our university-based practice, all surgeons adhered to the following treatment approaches: Before 2000 no dual-mobility implants or constrained liners were used for primary THAs. 2 ) who received standard cups, 85 hips in patients with bariatric surgery before THA using standard cups (with reduction to a BMI \ 30 kg/m 2 ), and 155 hips in patients with obesity who received dual-mobility (when younger than 70 years) or constrained liners (when older than 70 years). All patients received the same implants except for different femoral head diameters (32-mm head with standard cups and 28-mm head with dual-mobility or constrained liners). The patients were followed at routine intervals and were specifically queried about dislocation. All the 670 hips had a minimum followup of 5 years with a mean followup of 14 years (range 5-25 years). At the most recent followup, 101 (15%) hips were lost to followup (respectively, 36 of 215, 34 of 215, five of 85, 24 of 155), which is the same ratio as observed among the underlying populations from which the patients were drawn.Each author certifies that he or she, or a member of his or her immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

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Clinical Impact of Obesity on Stability Following Revision Total Hip Arthroplasty

Cited by 78 publications

References 23 publications

High body mass index is associated with increased risk of implant dislocation following primary total hip replacement: 2,106 patients followed for up to 8 years

High body mass index is associated with increased risk of implant dislocation following primary total hip replacement: 2,106 patients followed for up to 8 years

Outcomes of Isolated Acetabular Revision

Dual-mobility or Constrained Liners Are More Effective Than Preoperative Bariatric Surgery in Prevention of THA Dislocation

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