Hip Arthroplasty in Morbidly Obese Patients – Intra-Operative and Short Term Outcomes

Concerns about longer and more difficult operations, increased early post-operative complications and poorer patient outcomes may deter surgeons from performing total hip arthroplasty (THA) on morbidly obese (MO) patients. Intra-operative parameters including operation time, anaesthetic time, wound length and length of hospital stay were compared between 29 MO THA patients (Body Mass Index (BMI) > 40 kg/m²) and 29 age and gender matched THA patients with normal BMI (BMI between 20 and 25 kg/m²) in a single surgeon study. Pre and post-operative Oxford Hip scores, hip range of motion and post-operative complications were also compared.

Morbidly obese patients experienced significantly longer operation times (66 minutes) and longer wounds (14.2 cm) compared to normal THA patients (58 minutes and 12.1 cm respectively). However, intra-operative anaesthetic time and length of hospital stay were not significantly different between the MO and normal patients. Improvements in patient outcomes following THA were not significantly different between the MO and normal patients at one year follow-up. Improvements in sagittal range of motion and external rotation were significantly less for MO patients. Intraoperative complication rates were 0% for the MO and 3.5% for the normal patients. Postoperative complication rates were 3.5% for the MO and 0% for the normal patients. THA operation times for MO patients were on average only 8 minutes longer and should not represent a barrier to surgery. Hospital length of stay was not longer for MO patients suggesting they do not represent a greater burden on healthcare resources during THA.