title: A minimally invasive approach for total hip arthroplasty does not diminish early post-operative outcome in obese patients: a prospective, randomised trial.
abstract: OBJECTIVE
  The benefits of minimally invasive surgical techniques in total hip arthroplasty (THA) are well known, but concerns about applying those techniques in obese patients are controversial. We prospectively compared patients with increased body mass index (BMI ≥ 30) undergoing THA with normal weight patients.
  
  
  METHODS
  A total of 134 patients admitted for unilateral THA were randomised to have surgery through either a transgluteal or a minimally invasive approach (MicroHip). In each group a BMI ≥ 30 was used to define obese patients. Pre- and early post-operative demographics, intraoperative data, baseline haematological values, hip function (Harris Hip Score, Oxford Hip Score) and quality of life (EQ-5D) were assessed with follow-up at three months.
  
  
  RESULTS
  Duration of surgery, blood loss, C-reactive protein levels, radiographic measurements and complication rates were comparable in all groups. There was a tendency for lower serum creatine kinase levels in the MicroHip group. Intraoperative fluoroscopic time and dose area products were significantly elevated in patients with a BMI exceeding 30 regardless of the approach used. Time points of mobilisation, length of hospital stay and functional outcome measurements were similar in the different weight groups.
  
  
  CONCLUSIONS
  Our data suggest that obese patients gain similar benefit from MicroHip THA as do non-obese patients. The results of this study should be further investigated to assess long-term survivorship.
authors: Department of Orthopaedic Surgery, Regensburg University Medical Center, Asklepios Klinikum Bad Abbach, Kaiser-Karl V.-Allee 3, 93077, Bad Abbach, Germany. tdienstknecht@ukaachen.de
authors: Thomas
authors: T
authors: Dienstknecht
authors: Christian
authors: C
authors: Lüring
authors: Markus
authors: M
authors: Tingart
authors: Joachim
authors: J
authors: Grifka
authors: Ernst
authors: E
authors: Sendtner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D016063:Blood Loss, Surgical; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009765:Obesity / Q000150:complications*; D061646:Operative Time; D015207:Osteoarthritis, Hip / Q000209:etiology* / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D011184:Postoperative Period; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome
chemical_list: D002097:C-Reactive Protein