title: Obesity in total hip arthroplasty: does it make a difference?
abstract: OBJECTIVE
  The purpose of our study is to summarise the current scientific findings regarding the impact of obesity on total hip arthroplasty (THA); specifically the influence of obesity on the timing of THA, incidence of complications, and effect on clinical and functional outcomes.
  
  
  METHODS
  We performed a systematic review that was compliant with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify prospective studies from the PubMed/Medline, Embase, and Cochrane Library databases that evaluated primary THA in obese (body mass index (BMI) ≥ 30 kg/m2) patients.
  
  
  RESULTS
  There were 17 articles included in the review, which encompassed 13 722 THA patients. Analysis of the included studies showed that, when compared with non-obese patients, obesity was associated with younger age at time of primary THA, and an increased incidence of complications (up to four-fold). Results were mixed on the influence of obesity on the outcomes of primary THA, with three studies showing a detrimental effect on outcomes of a BMI ≥ 30 kg/m2, while eight studies showed no effect.
  
  
  CONCLUSIONS
  Obesity is associated with significantly younger age at time of primary THA and obese patients are likely to experience a higher rate of peri-operative complications. More investigation is needed into the effect of obesity on clinical outcomes, as the current literature is mixed. Cite this article: Bone Joint J 2017;99-B(1 Supple A):31-6.
authors.affiliation: Washington University Orthopedics, Barnes Jewish Hospital, 660 S. Euclid Avenue, Campus Box 8233, St. Louis, MO 63110, USA.
authors.forename: J
authors.initials: J
authors.lastname: Haynes
authors.affiliation: Washington University Orthopedics, Barnes Jewish Hospital, 660 S. Euclid Avenue, Campus Box 8233, St. Louis, MO 63110, USA.
authors.forename: D
authors.initials: D
authors.lastname: Nam
authors.affiliation: Washington University Orthopedics, Barnes Jewish Hospital, 660 S. Euclid Avenue, Campus Box 8233, St. Louis, MO 63110, USA.
authors.forename: R L
authors.initials: RL
authors.lastname: Barrack
mesh_terms: D000367:Age Factors; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D006617:Hip Dislocation / Q000209:etiology; D006801:Humans; D009765:Obesity / Q000150:complications*; D011183:Postoperative Complications; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Complications; Economic burden; Obesity; Outcomes; Total hip arthroplasty