The Impact of Obesity on Total Hip Arthroplasty Outcomes: A Retrospective Matched Cohort Study

Aggarwal, Vikram A; Sambandam, Senthil; Wukich, Dane K.

doi:10.7759/cureus.27450

Cited by 6 publications

(11 citation statements)

References 33 publications

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“…Out of a total of 759 related studies, 9 publications have been screened for inclusion and released through June 2023, as shown in Figure 1. [18][19][20][21][22][23][24][25][26] The total sample size ranged from 121 to 702 360 subjects. Figure 2 shows the outcome of a bias evaluation for 9 nonrandomized controlled studies.…”

Section: Resultsmentioning

confidence: 99%

“…Out of a total of 759 related studies, 9 publications have been screened for inclusion and released through June 2023, as shown in Figure 1 18–26 . The total sample size ranged from 121 to 702 360 subjects.…”

Section: Resultsmentioning

confidence: 99%

“…In this meta‐analysis, there were 1 822 114 patients who received THA at baseline, of which 435 479 were obese and 1 386 665 were not obese 18–26 . Among those obese patients who had received THA, there was a significant increase in the risk of post‐operative bleeding at the operative site, depth of operative infection, and the risk of bleeding from the wound.…”

Section: Discussionmentioning

confidence: 97%

“…In this meta-analysis, there were 1 822 114 patients who received THA at baseline, of which 435 479 were obese and 1 386 665 were not obese. [18][19][20][21][22][23][24][25][26] Among those obese patients who had received THA, there was a significant increase in the risk of post-operative bleeding at the operative site, depth of operative infection, and the risk of bleeding from the wound. The results of this trial are analysed and demonstrated that in patients who have undergone complete hip replacement, intraoperative obese patients have a significantly increased risk of postoperative wound haematoma, deep surgical area infection and wound infection complications in surgical site wounds compared to non-obese patients.…”

Section: Discussionmentioning

confidence: 99%

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Impact of wound complications in obese versus non‐obese patients undergoing total hip arthroplasty: A meta‐analysis

Yang

Zhao

Wang

et al. 2023

International Wound Journal

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This meta‐analysis examined the post‐operative wound effect of both obese and non‐obese in total hip arthroplasty (THA) patients. To gather as complete an overview as possible, the researchers took advantage of 4 databases—PubMed, Embase, Cochrane Library and Web of Science—to conduct a critical assessment. Following the development of inclusion and exclusion criteria, the researchers evaluated the quality of each document. A total of 9 related trials were conducted to determine the 95% CI (CI) and OR using a fixed‐effect model. The final meta‐analyses were conducted with RevMan 5.3. Our findings indicate that there is no statistically significant benefit in terms of post‐operative wound complications among obese and non‐obese patients. Obese subjects had a significantly higher risk of injury than those without obesity (OR, 1.43; 95% CI, 1.04, 1.95, p = 0.03); obesity was also associated with a significantly higher risk of operative site infection than in non‐obese subjects (OR, 1.96; 95% CI, 1.76, 2.18, p < 0.0001); and after surgery, there was also a significant increase in the risk of post‐operative wound infections among obese subjects than in non‐obese subjects (OR, 1.57; 95% CI, 1.34, 1.84, p < 0.0001). However, due to the small size of the cohort study in this meta‐study, caution is required in the analysis. More randomized, controlled studies will be needed to validate these results.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Impact of wound complications in obese versus non‐obese patients undergoing total hip arthroplasty: A meta‐analysis

Yang

Zhao

Wang

et al. 2023

International Wound Journal

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“…Frisch et al demonstrated that a higher BMI significantly reduces the likelihood of perioperative blood transfusion in total hip arthroplasty and total knee arthroplasty [ 20 ]. There are several current publications concerning BMI, blood loss, and perioperative transfusions in orthopedic surgeries, and these studies advocate for lower transfusion rates in obese and overweight patients [ 21 , 22 , 23 , 24 ]. Thus, our results indicating lower blood transfusion requirements in the group with the highest BMI align with these previous findings.…”

Section: Discussionmentioning

confidence: 99%

The Association of Acetabulum Fracture and Mechanism of Injury with BMI, Days Spent in Hospital, Blood Loss, and Surgery Time: A Retrospective Analysis of 67 Patients

Wójcicki,

Pielak,

Walus

et al. 2024

Medicina

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Background and Objectives: The objective of this retrospective study was to investigate the association between acetabulum fractures; the mechanism of injury; and variables such as BMI, duration of hospital stay, blood loss, and surgery time. By exploring these factors, we aim to enhance our understanding of them and their impact on the healing process and the subsequent management of pelvic fractures. Materials and Methods: This study included 67 of 136 consecutive patients who were admitted for pelvic ring fracture surgery between 2017 and 2022. The data were collected prospectively at a single trauma center. The inclusion criteria were acetabulum fractures and indications for operative treatment. The exclusion criteria were non-operative treatment for acetabular and pelvic ring fractures, fractures requiring primary total hip arthroplasty (THA), and periprosthetic acetabular fractures. Upon admission, all patients underwent evaluation using X-ray and computed tomography (CT) scans of the pelvis. Results: The present study found no statistically significant differences between the examined groups of patients with pelvic fractures in terms of BMI, surgery duration, length of hospital stay, and blood transfusion. However, two notable findings approached statistical significance. Firstly, patients who experienced a fall from height while sustaining a pelvic fracture required a higher number of blood transfusions (2.3 units) than those with other mechanisms of injury which was close to achieving statistical significance (p = 0.07). Secondly, patients undergoing posterior wall stabilization required a significantly lower number of blood transfusions than those with other specific pelvic injuries (0.33 units per patient), approaching statistical significance (p = 0.056). Conclusions: The findings indicated that factors such as BMI, time of surgery, blood loss, and the duration of hospital stay were not directly correlated with the morphology of acetabular fractures, the presence of additional trauma, or the mechanism of injury. However, in the studied group, the patients whose mechanism of trauma involved falling from height had an increased number of blood transfusions compared to other groups. Moreover, the patients who had surgery due to posterior wall acetabulum fracture had decreased blood transfusions compared to those with other Judet and Letournel types of fractures. Additionally, they had the shortest duration of surgery.

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An analysis of the prevalence and risk factors of deep vein thrombosis in non-fracture patients awaiting total hip arthroplasty: a retrospective study of 1244 cases

Yao,

Chai,

Qiao

et al. 2024

J Orthop Surg Res

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Background Deep vein thrombosis (DVT) has been one of the most dangerous complications in total hip arthroplasty (THA). If a patient’s pre-surgical DVT is overlooked, it can easily be mistaken for a post-operative thrombus and lead to an increased risk of DVT during and after surgery. This retrospective study was to explore the incidence and associated risk factors of deep vein thrombosis (DVT) in non-fracture patients before total hip arthroplasty (THA). Methods From September 2015 to September 2020, 1242 patients admitted for THA were enrolled with 1120 patients (90.2%) for primary THA and 122 patients (9.8%) for revision THA. An experienced sonographer performed a bedside ultrasound to detect DVT in bilateral lower limbs preoperatively. Univariate and logistic regression analysis was performed to identify the independent risk factors. Results 38 patients (3.1%) were detected with preoperative DVT. Univariate analysis showed that age (P < 0.001), D-dimer level (P = 0.002), female patients (P = 0.016), revision THA (P < 0.001), Barthel Index score (P = 0.010) were significantly associated with preoperative DVT. In subgroup comparison, the incidence of DVT increased with age significantly (P < 0.001) and D-dimer level (P < 0.001). In logistic regression analysis, age ≥ 75 years old (odds ratio [OR] 3.678, 95% CI [2.197–18.721], P < 0.001), gender (OR 2.709, 95% CI [1.244–5.896], P = 0.012), higher D-dimer ≥ 0.5 mg/l (OR 6.841, 95% CI [2.197–18.721], P < 0.001) and revision THA (OR 2.240, 95% CI [1.143–5.372], P = 0.05) were confirmed as the independent risk factors. Conclusions The incidence of preoperative DVT in non-fracture patients was 3.1%, with 2.4% in primary THA and 9.0% in revision THA. Age ≥ 75 years old, female, D-dimer ≥ 0.5 mg/l, and revision THA were independent risk factors. When evaluating the risk factors associated with thrombus formation preoperatively, it is important to take these into account before surgery.

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The Impact of Obesity on Total Hip Arthroplasty Outcomes: A Retrospective Matched Cohort Study

Cited by 6 publications

References 33 publications

Impact of wound complications in obese versus non‐obese patients undergoing total hip arthroplasty: A meta‐analysis

Impact of wound complications in obese versus non‐obese patients undergoing total hip arthroplasty: A meta‐analysis

The Association of Acetabulum Fracture and Mechanism of Injury with BMI, Days Spent in Hospital, Blood Loss, and Surgery Time: A Retrospective Analysis of 67 Patients

An analysis of the prevalence and risk factors of deep vein thrombosis in non-fracture patients awaiting total hip arthroplasty: a retrospective study of 1244 cases

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