Outcomes of morbidly obese patients undergoing total hip arthroplasty with the anterior-based muscle-sparing approach
Aims: Obesity is associated with an increased risk of hip osteoarthritis, resulting in an increased number of total hip arthroplasties (THAs) performed annually. This study examines the peri- and postoperative outcomes of morbidly obese (MO) patients (BMI ≥ 40 kg/m2) compared to healthy weight (HW)...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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The British Editorial Society of Bone & Joint Surgery
2023-05-01
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| Series: | Bone & Joint Open |
| Subjects: | |
| Online Access: | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.45.BJO-2022-0140.R2 |
| _version_ | 1827939427345760256 |
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| author | Bailey E. Shevenell Johanna Mackenzie Lillian Fisher Brian McGrory George Babikian Adam J. Rana |
| author_facet | Bailey E. Shevenell Johanna Mackenzie Lillian Fisher Brian McGrory George Babikian Adam J. Rana |
| author_sort | Bailey E. Shevenell |
| collection | DOAJ |
| description | Aims: Obesity is associated with an increased risk of hip osteoarthritis, resulting in an increased number of total hip arthroplasties (THAs) performed annually. This study examines the peri- and postoperative outcomes of morbidly obese (MO) patients (BMI ≥ 40 kg/m2) compared to healthy weight (HW) patients (BMI 18.5 to < 25 kg/m2) who underwent a THA using the anterior-based muscle-sparing (ABMS) approach. Methods: This retrospective cohort study observes peri- and postoperative outcomes of MO and HW patients who underwent a primary, unilateral THA with the ABMS approach. Data from surgeries performed by three surgeons at a single institution was collected from January 2013 to August 2020 and analyzed using Microsoft Excel and Stata 17.0. Results: This study compares 341 MO to 1,140 HW patients. Anaesthesia, surgery duration, and length of hospital stay was significantly lower in HW patients compared to MO. There was no difference in incidence of pulmonary embolism, periprosthetic fracture, or dislocation between the two groups. The rate of infection in MO patients (1.47%) was significantly higher than HW patients (0.14%). Preoperative patient-reported outcome measures (PROMs) show a significantly higher pain level in MO patients and a significantly lower score in functional abilities. Overall, six-week and one-year postoperative data show higher levels of pain, lower levels of functional improvement, and lower satisfaction scores in the MO group. Conclusion: The comorbidities of obesity are well studied; however, the implications of THA using the ABMS approach have not been studied. Our peri- and postoperative results demonstrate significant improvements in PROMs in MO patients undergoing THA. However, the incidence of deep infection was significantly higher in this group compared with HW patients. Cite this article: Bone Jt Open 2023;4(5):299–305. |
| first_indexed | 2024-03-13T08:53:21Z |
| format | Article |
| id | doaj.art-7d222d98c3264c4ea6dd954a94b242bc |
| institution | Directory Open Access Journal |
| issn | 2633-1462 |
| language | English |
| last_indexed | 2024-03-13T08:53:21Z |
| publishDate | 2023-05-01 |
| publisher | The British Editorial Society of Bone & Joint Surgery |
| record_format | Article |
| series | Bone & Joint Open |
| spelling | doaj.art-7d222d98c3264c4ea6dd954a94b242bc2023-05-29T05:54:46ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Open2633-14622023-05-014529930510.1302/2633-1462.45.BJO-2022-0140.R2Outcomes of morbidly obese patients undergoing total hip arthroplasty with the anterior-based muscle-sparing approachBailey E. Shevenell0Johanna Mackenzie1Lillian Fisher2Brian McGrory3George Babikian4Adam J. Rana5Maine Medical Partners Orthopedics Joint Replacement, Falmouth, Maine, USAMaine Medical Partners Orthopedics Joint Replacement, Falmouth, Maine, USAMaine Medical Partners Orthopedics Joint Replacement, Falmouth, Maine, USAMaine Medical Partners Orthopedics Joint Replacement, Falmouth, Maine, USAMaine Medical Partners Orthopedics Joint Replacement, Falmouth, Maine, USAMaine Medical Partners Orthopedics Joint Replacement, Falmouth, Maine, USAAims: Obesity is associated with an increased risk of hip osteoarthritis, resulting in an increased number of total hip arthroplasties (THAs) performed annually. This study examines the peri- and postoperative outcomes of morbidly obese (MO) patients (BMI ≥ 40 kg/m2) compared to healthy weight (HW) patients (BMI 18.5 to < 25 kg/m2) who underwent a THA using the anterior-based muscle-sparing (ABMS) approach. Methods: This retrospective cohort study observes peri- and postoperative outcomes of MO and HW patients who underwent a primary, unilateral THA with the ABMS approach. Data from surgeries performed by three surgeons at a single institution was collected from January 2013 to August 2020 and analyzed using Microsoft Excel and Stata 17.0. Results: This study compares 341 MO to 1,140 HW patients. Anaesthesia, surgery duration, and length of hospital stay was significantly lower in HW patients compared to MO. There was no difference in incidence of pulmonary embolism, periprosthetic fracture, or dislocation between the two groups. The rate of infection in MO patients (1.47%) was significantly higher than HW patients (0.14%). Preoperative patient-reported outcome measures (PROMs) show a significantly higher pain level in MO patients and a significantly lower score in functional abilities. Overall, six-week and one-year postoperative data show higher levels of pain, lower levels of functional improvement, and lower satisfaction scores in the MO group. Conclusion: The comorbidities of obesity are well studied; however, the implications of THA using the ABMS approach have not been studied. Our peri- and postoperative results demonstrate significant improvements in PROMs in MO patients undergoing THA. However, the incidence of deep infection was significantly higher in this group compared with HW patients. Cite this article: Bone Jt Open 2023;4(5):299–305.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.45.BJO-2022-0140.R2total hip arthroplastyable™ approachanterior-based muscle-sparing (abms) approachobesityrottinger approachmodified watson-jones approachbmimorbidly obesetotal hip arthroplasties (thas)patient-reported outcome measures (proms)infectionsdeep infectionsanaesthesiaperiprosthetic fracturecomorbidities |
| spellingShingle | Bailey E. Shevenell Johanna Mackenzie Lillian Fisher Brian McGrory George Babikian Adam J. Rana Outcomes of morbidly obese patients undergoing total hip arthroplasty with the anterior-based muscle-sparing approach Bone & Joint Open total hip arthroplasty able™ approach anterior-based muscle-sparing (abms) approach obesity rottinger approach modified watson-jones approach bmi morbidly obese total hip arthroplasties (thas) patient-reported outcome measures (proms) infections deep infections anaesthesia periprosthetic fracture comorbidities |
| title | Outcomes of morbidly obese patients undergoing total hip arthroplasty with the anterior-based muscle-sparing approach |
| title_full | Outcomes of morbidly obese patients undergoing total hip arthroplasty with the anterior-based muscle-sparing approach |
| title_fullStr | Outcomes of morbidly obese patients undergoing total hip arthroplasty with the anterior-based muscle-sparing approach |
| title_full_unstemmed | Outcomes of morbidly obese patients undergoing total hip arthroplasty with the anterior-based muscle-sparing approach |
| title_short | Outcomes of morbidly obese patients undergoing total hip arthroplasty with the anterior-based muscle-sparing approach |
| title_sort | outcomes of morbidly obese patients undergoing total hip arthroplasty with the anterior based muscle sparing approach |
| topic | total hip arthroplasty able™ approach anterior-based muscle-sparing (abms) approach obesity rottinger approach modified watson-jones approach bmi morbidly obese total hip arthroplasties (thas) patient-reported outcome measures (proms) infections deep infections anaesthesia periprosthetic fracture comorbidities |
| url | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.45.BJO-2022-0140.R2 |
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