title: Is the long-term outcome of cemented THA jeopardized by patients being overweight?
abstract: Although the effect of being overweight on the long- and short-term outcome of THA remains unclear, the majority of orthopaedic surgeons believe being overweight negatively influences the longevity of a hip implant. We asked whether complications and long-term survival of cemented THA differed in overweight patients (body mass index [BMI] > 25 kg/m2) and obese patients (BMI > 30 kg/m2) compared with normal-weight patients (BMI < 25 kg/m2). We retrospectively analyzed 411 consecutive patients (489 THAs) treated with cemented THA between 1974 and 1993. Except for cardiovascular comorbidity, we observed no differences in demographics among these weight groups. We found no differences in the number of intraoperative or postoperative complications. The survival rates for the three BMI groups were similar. The 10-year survival for any revision was 94.9% (95% confidence interval, 91.6%-98.2%), 90.4% (95% confidence interval, 85.6%-95.2%), and 91% (95% confidence interval, 81.2%-100%) for normal-weight, overweight, and obese patients, respectively. Cox regression analysis showed BMI and weight had no major influence on survival rates. The differences in mean Harris hip score at final followup were 4.8 between normal-weight and overweight patients and 7.1 between normal-weight and obese patients. Being overweight and obesity had no influence on perioperative complication rates in this cohort and did not negatively influence the long-term survival of cemented THA.
authors.affiliation: Department of Orthopedic Surgery G4-No, Academic Medical Centre Amsterdam, Orthopaedic Research Centre Amsterdam, PO Box 22660, 1100DD, Amsterdam, The Netherlands. D.Haverkamp@osteotomie.nl
authors.forename: Daniël
authors.initials: D
authors.lastname: Haverkamp
authors.forename: F Harald R
authors.initials: FH
authors.lastname: de Man
authors.forename: Pieter T
authors.initials: PT
authors.lastname: de Jong
authors.forename: Renée A
authors.initials: RA
authors.lastname: van Stralen
authors.forename: René K
authors.initials: RK
authors.lastname: Marti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D015992:Body Mass Index; D001843:Bone Cements; D005260:Female; D006621:Hip Joint / Q000503:physiopathology / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D007592:Joint Diseases / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D050177:Overweight / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D011475:Prosthesis Failure; D020127:Recovery of Function; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements