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Research Article

Obesity in total hip arthroplasty—does it really matter?

A meta-analysis

, , , &
Pages 417-422 | Received 18 Nov 2010, Accepted 11 Mar 2011, Published online: 10 Jun 2011
 

Abstract

Background and purpose Discussion persists as to whether obesity negatively influences the outcome of hip arthroplasty. We performed a meta-analysis with the primary research question of whether obesity has a negative effect on short- and long-term outcome of total hip arthroplasty.

Methods We searched the literature and included studies comparing the outcome of hip arthroplasty in different weight groups. The methodology of the studies included was scored according to the Cochrane guidelines. We extracted and pooled the data. For continuous data, we calculated a weighted mean difference and for dichotomous variables we calculated a weighted odds ratio (OR). Heterogeneity was calculated using I2 statistics.

Results 15 studies were eligible for data extraction. In obese patients, dislocation of the hip (OR = 0.54, 95% CI: 0.38–0.75) (10 studies, n = 8,634), aseptic loosening (OR = 0.64, CI: 0.43–0.96) (6 studies, n = 5,137), infection (OR = 0.3, CI: 0.19–0.49) (10 studies, n = 7,500), and venous thromboembolism (OR = 0.56, CI: 0.32–0.98) (7 studies, n = 3,716) occurred more often. Concerning septic loosening and intraoperative fractures, no statistically significant differences were found, possibly due to low power. Subjective outcome measurements did not allow pooling because of high heterogeneity (I2 = 68%).

Interpretation Obesity appears to have a negative influence on the outcome of total hip replacement.

DH: study design, protocol, data search, data extraction, and writing of manuscript. MNK: data search and methodology scoring. MPS: arbitration of data search, methodology scoring, and data verification. GHRA: study design, protocol, and revision of manuscript. HMvdV: study design, protocol, and revision of manuscript.

No competing interests declared.