title: Overweight and obesity in hip and knee arthroplasty: Evaluation of 6078 cases.
abstract: OBJECTIVE
  To evaluate a possible association between the various levels of obesity and peri-operative charac-teristics of the procedure in patients who underwent endoprosthetic joint replacement in hip and knee joints.
  
  
  METHODS
  We hypothesized that obese patients were treated for later stage of osteoarthritis, that more conservative implants were used, and the intra-and perioperative complications increased for such patients. We evaluated all patients with body mass index (BMI) ≥ 25 who were treated in our institution from January 2011 to September 2013 for a primary total hip arthroplasty (THA) or total knee arthroplasty (TKA). Patients were split up by the levels of obesity according to the classification of the World Health Organization. Average age at the time of primary arthroplasty, preoperative Harris Hip Score (HHS), Hospital for Special Surgery score (HSS), gender, type of implanted prosthesis, and intra-and postoperative complications were evaluated.
  
  
  RESULTS
  Six thousand and seventy-eight patients with a BMI ≥ 25 were treated with a primary THA or TKA. Age decreased significantly (P < 0.001) by increasing obesity in both the THA and TKA. HHS and HSS were at significantly lower levels at the time of treatment in the super-obese population (P < 0.001). Distribution patterns of the type of endoprostheses used changed with an increasing BMI. Peri- and postoperative complications were similar in form and quantity to those of the normal population.
  
  
  CONCLUSIONS
  Higher BMI leads to endoprosthetic treat-ment in younger age, which is carried out at significantly lower levels of preoperative joint function.
authors.affiliation: Daniel Guenther, Stefan Schmidl, Till O Klatte, Thorsten Gehrke, Daniel Kendoff, Carl Haasper, Orthopaedic Department, Helios-Endo Klinik Hamburg, Hamburg 22767, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Guenther
authors.affiliation: Daniel Guenther, Stefan Schmidl, Till O Klatte, Thorsten Gehrke, Daniel Kendoff, Carl Haasper, Orthopaedic Department, Helios-Endo Klinik Hamburg, Hamburg 22767, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Schmidl
authors.affiliation: Daniel Guenther, Stefan Schmidl, Till O Klatte, Thorsten Gehrke, Daniel Kendoff, Carl Haasper, Orthopaedic Department, Helios-Endo Klinik Hamburg, Hamburg 22767, Germany.
authors.forename: Till O
authors.initials: TO
authors.lastname: Klatte
authors.affiliation: Daniel Guenther, Stefan Schmidl, Till O Klatte, Thorsten Gehrke, Daniel Kendoff, Carl Haasper, Orthopaedic Department, Helios-Endo Klinik Hamburg, Hamburg 22767, Germany.
authors.forename: Harald K
authors.initials: HK
authors.lastname: Widhalm
authors.affiliation: Daniel Guenther, Stefan Schmidl, Till O Klatte, Thorsten Gehrke, Daniel Kendoff, Carl Haasper, Orthopaedic Department, Helios-Endo Klinik Hamburg, Hamburg 22767, Germany.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Omar
authors.affiliation: Daniel Guenther, Stefan Schmidl, Till O Klatte, Thorsten Gehrke, Daniel Kendoff, Carl Haasper, Orthopaedic Department, Helios-Endo Klinik Hamburg, Hamburg 22767, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Krettek
authors.affiliation: Daniel Guenther, Stefan Schmidl, Till O Klatte, Thorsten Gehrke, Daniel Kendoff, Carl Haasper, Orthopaedic Department, Helios-Endo Klinik Hamburg, Hamburg 22767, Germany.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Gehrke
authors.affiliation: Daniel Guenther, Stefan Schmidl, Till O Klatte, Thorsten Gehrke, Daniel Kendoff, Carl Haasper, Orthopaedic Department, Helios-Endo Klinik Hamburg, Hamburg 22767, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Kendoff
authors.affiliation: Daniel Guenther, Stefan Schmidl, Till O Klatte, Thorsten Gehrke, Daniel Kendoff, Carl Haasper, Orthopaedic Department, Helios-Endo Klinik Hamburg, Hamburg 22767, Germany.
authors.forename: Carl
authors.initials: C
authors.lastname: Haasper
keywords: Adiposity; Obesity; Overweight; Prosthesis; Total hip arthroplasty; Total knee arthroplasty