A comparison of the perioperative morbidity in total joint arthroplasty in the obese and nonobese patient.
The goal of this study was to determine if obesity is a risk factor for total joint arthroplasty. This was a retrospective review of 130 patients treated with either primary total hip arthroplasty or primary total knee arthroplasty during a two-year period (154 consecutive arthroplasties). The patients were placed in the nonobese or obese group. Obesity was defined as 20% above ideal weight for height, based on life insurance tables. There were 51 in the nonobese groups and 103 in the obese group. Charts were reviewed for a number of factors associated with postoperative complications. Operative time, intravenous fluids administered, and total blood loss were found to be slightly higher in the obese group. Only the difference in operative time proved statistically significant, however. The hospitalization time, number of days with a fever, number of transfusions, preoperative and postoperative hemoglobin levels, and days requiring intramuscular narcotics were very similar between the two groups. There were 0.29 minor complications per nonobese patient, but only 0.22 per obese patient. Major complications were encountered 0.22 times per nonobese patient and 0.10 times per obese patient. The patient is not necessarily at a higher risk for peroperative complications in total joint arthroplasty. The longevity of the implant in the obese patient was not determined in this perioperative study.
Jiganti
J J
JJ
Department of Orthopedics, Lutheran General Hospital, Park Ridge, Illinois.
Goldstein
W M
WM
Williams
C S
CS
D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D001803:Blood Transfusion / Q000706:statistics & numerical data; D001835:Body Weight; D005260:Female; D005440:Fluid Therapy / Q000706:statistics & numerical data; D006454:Hemoglobins / Q000032:analysis; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects; D007902:Length of Stay / Q000706:statistics & numerical data; D015993:Life Tables; D008297:Male; D009294:Narcotics / Q000627:therapeutic use; D009765:Obesity / Q000150:complications* / Q000175:diagnosis; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
D006454:Hemoglobins; D009294:Narcotics