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Table 1 Retrospective studies of functional outcomes in obese and non-obese patients with total hip arthroplasty (THA)

From: Obesity and long term functional outcomes following elective total hip replacement

Study

N Follow-up

Sample

Surgical Type & Components

Results

Braeken et al [2] (1997)

193 to 1 year; Retrospective Mean age 63.5 years

61% were women BMI was found for each patient

Surgical components not described; surgical type not described: data obtained from medical charts and mailings

While high BMI was related to high postoperative pain levels, BMI itself was not a strong contributor to the regression model for WOMAC functional score (parameter estimate value of 0.092).

Haverkamp et al [14] (2008)

411 Mean out to 20 years; Retrospective

69% were women; BMI groups were <25, ≥ 25 and >30 kg/m2 Mean ages were 64–66 years among groups

Anterolateral approach; Weber rotation THA System (Allopro) with cement;

HHS scores were progressively lower for higher BMI brackets at maximum follow-up time (91.6, 86.8 and 83.7 points; p = 0.02); revision rates were similar among BMI complication rates and groups

LeDuff et al [7] (2007)

770 2–10 years; Retrospective

17% were women BMI groups were < or ≥ 30 kg/m2 Mean age 49 years

Posterior approach; 30-37% of metaphyseal stem femoral components were cemented; Conserve Plus hip resurfacing prostheses were used

By 6.2 years of follow-up, UCLA scores for function and activity werelower in the obese patients than non-obese patients by ~8%; SF-12 physical component scores were also lower in the obese group (49.3 vs 51.4 points; p = 0.013); 5 year survivorship was 90.6% and 98.6% in patients with BMI <25 and 30 kg/m2, respectively.

McLaughlin & Lee [33]

285 10–18 years; Retrospective

51% were women; BMI groups were <30 or ≥30 kg/m2 Mean ages 54–57 years

Uncemented T-tap acetabular components (Biomet Inc.) and Taperloc femoral points in obese patients and from 53 to components were used by one surgeon; all were posterolateral approaches

By follow-up HHS ↑ from 52 to 89 89 points in non-obese patients, with no difference between groups; no differences in revision rates or complications occurred between groups

Yeung et al [24] (2010)

2,026 6.3 year mean follow-up; Retrospective

53% were female; BMI groups were <30 or ≥30 kg/m2

Cementless procedures used; components and approached were not described

HHS scores were lower for the obese compared to the non-obese patients at follow-up (89.9 vs 93.2 points; p < 0.001); HHS scores for function, activities, hip range of motion were lower in the obese group (all p < 0.05); survival rates were for the implants were similar at year 11 (95-96%)

  1. THA = total hip arthroplasty; BMI = body mass index; EUROHIP = European Collaborative Database of Cost and Practice Patterns of Total Hip Replacement.
  2. OR = odds ratio; RR = relative risk; HHS = Harris Hip Score; UCLA = University of California and Los Angeles (UCLA) activity scale; Medical Outcomes SF-12 = Short Form 12; WOMAC = Western Ontario and McMaster Osteoarthritis Index; VAS = visual analogue scale.
  3. NS = not specified.