Clinical Outcome of Primary Total Hip Arthroplasty in Patients with Morbid Obesity—Retrospective and Prospective Follow-Up Studies

<i>Background and objective:</i> There is a general clinical concern on the negative impact of obesity on surgical complications and functional outcomes. We hypothesized that the patients with morbid obesity are exceptionally prone to a significantly increased risk for surgical and short...

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Autores principales:	Andrey Gritsyuk, Alexey Lychagin, Liu Yi, Nahum Rosenberg
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	hip arthroplasty obesity surgical complications hip arthritis functional outcome Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/91953a16d6cd4b0fae58d8fff18ba326
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spelling	oai:doaj.org-article:91953a16d6cd4b0fae58d8fff18ba3262021-11-25T18:18:55ZClinical Outcome of Primary Total Hip Arthroplasty in Patients with Morbid Obesity—Retrospective and Prospective Follow-Up Studies10.3390/medicina571112471648-91441010-660Xhttps://doaj.org/article/91953a16d6cd4b0fae58d8fff18ba3262021-11-01T00:00:00Zhttps://www.mdpi.com/1648-9144/57/11/1247https://doaj.org/toc/1010-660Xhttps://doaj.org/toc/1648-9144<i>Background and objective:</i> There is a general clinical concern on the negative impact of obesity on surgical complications and functional outcomes. We hypothesized that the patients with morbid obesity are exceptionally prone to a significantly increased risk for surgical and short-term complications after primary total hip arthroplasty (THA). We aimed to identify the range of Body Mass Index (BMI) values of patients with a significant risk for lower functional improvement after THA. <i>Materials and methods:</i> In Stage 1 of the study, we conducted a retrospective comparative analysis of the rate of complications and functional outcomes in patients treated by primary THA, with normal weight (BMI 19–25, <i>N</i> = 1205) vs. Class 1 (BMI 26–34, <i>N</i> = 450), Class 2 (BMI 35–39, <i>N</i> = 183), and Class 3 (BMI ≥ 40, <i>N</i> = 47) obese patients. After the statistical similarity rates of complications and 6- and 12-month functional outcomes (by Harris Hip and SF-36 scores) were revealed in Class 1 patients and patients with normal BMI, we conducted the Stage 2 prospective study, by the same comparison protocol, on the cohorts of Class 2 (<i>N</i> = 29) and Class 3 (<i>N</i> = 16) patients compared to the Class 1 patients (<i>N</i> = 37) as controls. <i>Results:</i> Stage 1: There was no difference in surgical complications and function on 6- and 12-month postoperative follow-up (physical and mental) between Class 1 and patients with normal BMI (<i>p</i> > 0.05). Surgical complications were significantly higher in Class 2 (<i>p</i> < 0.05) and Class 3 (<i>p</i> < 0.001) patients. Functional activity on the 12-month follow-up increased significantly in all study groups, but in the Class 3 patients, the functional parameters were significantly lower (0.001). The mental health status on the follow-up was similar in all study groups. Stage 2 study revealed similar to the retrospective study comparison of parameters, except for the significantly lower mental health scores in Class 2 and Class 3 patients (<i>p</i> < 0.05) and functional scores in Class 3 patients (<i>p</i> < 0.05). <i>Conclusion:</i> Although the functional ability increased in all patients, it was significantly lower in Class 3 patients (with morbid obesity). Therefore, the patients with Class 1 and Class 2 obesity should be conceptionally distinguished from Class 3 patients in the decision-making process for a primary THA because of the less favorable functional and mental health improvement in those with morbid obesity (Class 3).Andrey GritsyukAlexey LychaginLiu YiNahum RosenbergMDPI AGarticlehip arthroplastyobesitysurgical complicationship arthritisfunctional outcomeMedicine (General)R5-920ENMedicina, Vol 57, Iss 1247, p 1247 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	hip arthroplasty obesity surgical complications hip arthritis functional outcome Medicine (General) R5-920
spellingShingle	hip arthroplasty obesity surgical complications hip arthritis functional outcome Medicine (General) R5-920 Andrey Gritsyuk Alexey Lychagin Liu Yi Nahum Rosenberg Clinical Outcome of Primary Total Hip Arthroplasty in Patients with Morbid Obesity—Retrospective and Prospective Follow-Up Studies
description	<i>Background and objective:</i> There is a general clinical concern on the negative impact of obesity on surgical complications and functional outcomes. We hypothesized that the patients with morbid obesity are exceptionally prone to a significantly increased risk for surgical and short-term complications after primary total hip arthroplasty (THA). We aimed to identify the range of Body Mass Index (BMI) values of patients with a significant risk for lower functional improvement after THA. <i>Materials and methods:</i> In Stage 1 of the study, we conducted a retrospective comparative analysis of the rate of complications and functional outcomes in patients treated by primary THA, with normal weight (BMI 19–25, <i>N</i> = 1205) vs. Class 1 (BMI 26–34, <i>N</i> = 450), Class 2 (BMI 35–39, <i>N</i> = 183), and Class 3 (BMI ≥ 40, <i>N</i> = 47) obese patients. After the statistical similarity rates of complications and 6- and 12-month functional outcomes (by Harris Hip and SF-36 scores) were revealed in Class 1 patients and patients with normal BMI, we conducted the Stage 2 prospective study, by the same comparison protocol, on the cohorts of Class 2 (<i>N</i> = 29) and Class 3 (<i>N</i> = 16) patients compared to the Class 1 patients (<i>N</i> = 37) as controls. <i>Results:</i> Stage 1: There was no difference in surgical complications and function on 6- and 12-month postoperative follow-up (physical and mental) between Class 1 and patients with normal BMI (<i>p</i> > 0.05). Surgical complications were significantly higher in Class 2 (<i>p</i> < 0.05) and Class 3 (<i>p</i> < 0.001) patients. Functional activity on the 12-month follow-up increased significantly in all study groups, but in the Class 3 patients, the functional parameters were significantly lower (0.001). The mental health status on the follow-up was similar in all study groups. Stage 2 study revealed similar to the retrospective study comparison of parameters, except for the significantly lower mental health scores in Class 2 and Class 3 patients (<i>p</i> < 0.05) and functional scores in Class 3 patients (<i>p</i> < 0.05). <i>Conclusion:</i> Although the functional ability increased in all patients, it was significantly lower in Class 3 patients (with morbid obesity). Therefore, the patients with Class 1 and Class 2 obesity should be conceptionally distinguished from Class 3 patients in the decision-making process for a primary THA because of the less favorable functional and mental health improvement in those with morbid obesity (Class 3).
format	article
author	Andrey Gritsyuk Alexey Lychagin Liu Yi Nahum Rosenberg
author_facet	Andrey Gritsyuk Alexey Lychagin Liu Yi Nahum Rosenberg
author_sort	Andrey Gritsyuk
title	Clinical Outcome of Primary Total Hip Arthroplasty in Patients with Morbid Obesity—Retrospective and Prospective Follow-Up Studies
title_short	Clinical Outcome of Primary Total Hip Arthroplasty in Patients with Morbid Obesity—Retrospective and Prospective Follow-Up Studies
title_full	Clinical Outcome of Primary Total Hip Arthroplasty in Patients with Morbid Obesity—Retrospective and Prospective Follow-Up Studies
title_fullStr	Clinical Outcome of Primary Total Hip Arthroplasty in Patients with Morbid Obesity—Retrospective and Prospective Follow-Up Studies
title_full_unstemmed	Clinical Outcome of Primary Total Hip Arthroplasty in Patients with Morbid Obesity—Retrospective and Prospective Follow-Up Studies
title_sort	clinical outcome of primary total hip arthroplasty in patients with morbid obesity—retrospective and prospective follow-up studies
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/91953a16d6cd4b0fae58d8fff18ba326
work_keys_str_mv	AT andreygritsyuk clinicaloutcomeofprimarytotalhiparthroplastyinpatientswithmorbidobesityretrospectiveandprospectivefollowupstudies AT alexeylychagin clinicaloutcomeofprimarytotalhiparthroplastyinpatientswithmorbidobesityretrospectiveandprospectivefollowupstudies AT liuyi clinicaloutcomeofprimarytotalhiparthroplastyinpatientswithmorbidobesityretrospectiveandprospectivefollowupstudies AT nahumrosenberg clinicaloutcomeofprimarytotalhiparthroplastyinpatientswithmorbidobesityretrospectiveandprospectivefollowupstudies
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Clinical Outcome of Primary Total Hip Arthroplasty in Patients with Morbid Obesity—Retrospective and Prospective Follow-Up Studies

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