title: High body mass index is associated with increased risk of implant dislocation following primary total hip replacement: 2,106 patients followed for up to 8 years.
abstract: OBJECTIVE
  Implant dislocation is one of the commonest complications following primary total hip replacement (THR). We investigated the effect of body mass index (BMI) and tobacco use on the risk of this complication.
  
  
  METHODS
  Through linkage between the Swedish Construction Workers' cohort and the Swedish Inpatient Register, 2,106 male patients who had undergone primary THR between 1997 and 2004 were identified. We used Cox multivariable regression analysis to study the association between BMI and tobacco use and the risk of implant dislocation.
  
  
  RESULTS
  53 patients (2.5%) developed implant dislocation during a mean of 2 (0-3) years of follow-up. We found overweight and obesity to be associated with increased risk of implant dislocation (HR = 2.5,95% CI: 1.1-5.5 and HR = 3.7, 95% CI: 1.5-9.3, respectively as compared to those of normal weight). There was no statistically significant association between tobacco use and the risk of dislocation.
  
  
  CONCLUSIONS
  Greater attention should be given to high BMI as a risk factor for implant dislocation following THR.
authors.affiliation: Department of Medicine, Clinical Epidemiology Unit, Karolinska University Hospital Solna, Stockholm, Sweden. sayed-omid.sadrazodi@ki.se
authors.forename: Omid
authors.initials: O
authors.lastname: Sadr Azodi
authors.forename: Johanna
authors.initials: J
authors.lastname: Adami
authors.forename: David
authors.initials: D
authors.lastname: Lindström
authors.forename: Karl O
authors.initials: KO
authors.lastname: Eriksson
authors.forename: Andreas
authors.initials: A
authors.lastname: Wladis
authors.forename: Rino
authors.initials: R
authors.lastname: Bellocco
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D015992:Body Mass Index; D015331:Cohort Studies; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D017063:Outcome Assessment, Health Care; D050177:Overweight / Q000150:complications; D011475:Prosthesis Failure; D012042:Registries; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013548:Sweden