Underweight Patients are at Increased Risk for Complications following Total Hip Arthroplasty |
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| Affiliation: | 1. Department of Orthopedic Surgery, Alpert Medical School of Brown University, Providence, Rhode Island;2. Alpert Medical School of Brown University, Providence, Rhode Island;1. Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania;2. Department of Orthopaedics & Sports Medicine, Maine Medical Partners, South Portland, Maine;3. OrthoCarolina, Charlotte, North Carolina;4. American Association of Hip and Knee Surgeons, Chicago, Illinois;1. Department of Orthopedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea;2. Division of Biostatistics, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea;3. Department of Orthopedic Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea;1. Department of Orthopaedic Surgery, Western Health, Melbourne, Victoria, Australia;2. Swinburne University of Technology, Melbourne, Victoria, Australia;3. Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Victoria University, St. Albans, Victoria, Australia |
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| Abstract: | BackgroundGiven the prevalence of obesity in the United States, much of the adult reconstruction literature focuses on the effects of obesity and morbid obesity. However, there is little published data on the effect of being underweight on postoperative outcomes. This study aimed to examine the risk of low body mass index (BMI) on complications after total hip arthroplasty (THA).MethodsA large national database was queried between 2010 and 2020 to identify patients who had THAs. Using International Classification of Disease codes, patients were grouped into the following BMI categories: morbid obesity (BMI>40), obesity (BMI 30 to 40), normal BMI (BMI 20 to 30), and underweight (BMI<20). There were 58,151 patients identified, including 2,484 (4.27%) underweight patients, 34,710 (59.69%) obese patients, and 20,957 (36.04%) morbidly obese patients. Control groups were created for each study group, matching for age, sex, and a comorbidity index. Complications that occurred within 1 year postoperatively were isolated. Subanalyses were performed to compare complications between underweight and obese patients. Statistical analyses were performed using Pearson Chi-squares.ResultsCompared to their matched control group, underweight patients showed increased odds of THA revision (Odds Ratio (OR) = 1.32, P = .04), sepsis (OR = 1.51, P = .01), and periprosthetic fractures (OR = 1.63, P = .01). When directly comparing underweight and obese patients (BMI 30 and above), underweight patients had higher odds of aseptic loosening (OR = 1.62, P = .03), sepsis (OR = 1.34, P = .03), dislocation (OR = 1.84, P < .001), and periprosthetic fracture (OR = 1.46, P = .01).ConclusionMorbidly obese patients experience the highest odds of complications, although underweight patients also had elevated odds for several complications. Underweight patients are an under-recognized and understudied high risk arthroplasty cohort and further research is needed. |
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| Keywords: | underweight total hip arthroplasty complications obesity revision total hip arthroplasty |
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