Complications - OtherObesity is Associated With Early Total Hip Revision for Aseptic Loosening
Section snippets
Materials and Methods
Using the total joint registry of our institution (a tertiary care center), we retrospectively reviewed 273 primary THAs (261 patients) referred to Stanford Healthcare for a revision THA performed in a 3 year interval between January 2011 to December 2014. Sixteen patients were excluded from this study because they did not have a preoperative BMI or date of primary THA. As such, 257 primary THAs (245 patients) were reviewed for the final analysis. Age, gender, American Society of Anesthesiology
Results
When examining primary THAs referred for revision THA, the mean time from primary to revision THA was 8.7 ± 8.1 years. The time from primary THA to revision THA was directly correlated with increasing BMI (Fig. 1). The percentage of primary THAs revised at 5 years was 25% for a BMI of 18-25, 38% for a BMI of 25-30, 56% for a BMI of 30-35, 73% for a BMI of 35-40, and 75% for a BMI of more than 40 (P < .001). The percentage of primary THAs revised at 15 years was 70%, 82%, 87%, 94%, and 100%,
Discussion
The increasing number of patients undergoing primary THA coupled with the obesity epidemic should increase the number of obese and morbidly obese patients undergoing revision THA 4, 19, 20. Currently, there is conflicting evidence on whether obesity adversely impacts the survival of primary THA. In a large population-based survival analysis, Culliford et al. [18] showed that BMI is estimated to have a small but statistically significant association with risk of revision THA. However, little is
Acknowledgments
The authors thank Ms. Angela Bye and Dr. Subhrojyoti Bhowmick for their assistance searching the arthroplasty registry the Department of Orthopaedic Surgery at the Stanford Hospital and Clinics as well as selected editing of this manuscript.
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One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to http://dx.doi.org/10.1016/j.arth.2016.02.073.