Overweight and obesity in hip and knee arthroplasty:Evaluation of 6078 cases

作     者：Daniel Guenther Stefan Schmidl Till O Klatte Harald K Widhalm Mohamed Omar Christian Krettek Thorsten Gehrke Daniel Kendoff Carl Haasper 

作者机构：Orthopaedic DepartmentHelios-Endo Klinik Hamburg Trauma DepartmentHannover Medical School (MHH) Department of TraumaHandand Reconstructive SurgeryUniversity Medical Center Hamburg-Eppendorf Department of Trauma SurgeryMedical University of Vienna 

出 版 物：《World Journal of Orthopedics》 (世界骨科杂志（英文版）)

年 卷 期：2015年第6卷第1期

页      面：137-144页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Adiposity Total knee arthroplasty Total hip arthroplasty Obesity Overweight Prosthesis 

摘      要：AIM: To evaluate a possible association between thevarious levels of obesity and peri-operative characteristics 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 intraand 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 ***: 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. CONCLUSION: Higher BMI leads to endoprosthetic treatment in younger age, which is carried out at significantly lower levels of preoperative joint function.