TITLE

Influence of Obesity on Femoral Osteolysis Five and Ten Years Following Total Hip Arthroplasty

AUTHOR(S)
Lübbeke, Anne; Garavaglia, Guido; Barea, Christophe; Roussos, Constantinos; Stern, Richard; Hoffmeyer, Pierre
PUB. DATE
August 2010
SOURCE
Journal of Bone & Joint Surgery, American Volume;Aug2010, Vol. 92-A Issue 10, p1964
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: The most important long-term complication following total hip arthroplasty is periprosthetic femoral osteolysis. A sizeable proportion of patients who undergo arthroplasty are obese. While patient activity, implant type, and quality of fixation are known risk factors for osteolysis, the literature concerning obesity is sparse and controversial. Our primary objective was to evaluate the influence of obesity on the risk of osteolysis five and ten years after primary total hip arthroplasty with a cemented stem. Secondary objectives were to evaluate clinical outcome and patient satisfaction. Methods: We conducted a prospective cohort study of patients undergoing hip arthroplasty with a third-generation stem-cementing technique from 1996 to 2003. All patients were seen at five or ten years postoperatively. Radiographs and information regarding body-mass index (<25 kg/m² = normal weight, 25 to 29.9 kg/m² = overweight, and ≥30 kg/m² = obese) and activity were obtained. Activity was assessed with use of the University of California at Los Angeles (UCLA) activity scale. Osteolysis was assessed radiographically. Clinical outcome measurements included the Harris hip and Merle d'Aubigné and Postel scores. Results: Our study included 503 arthroplasties in 433 patients; the results of 241 (47.9%) of the arthroplasties were evaluated at five years and the results of 262 (52.1%), at ten years. Osteolysis was identified around forty-four stems, with twenty-four (13.3%) in 181 hips of normal-weight patients, eleven (5.4%) in 205 hips of overweight patients, and nine (7.7%) in 117 hips of obese patients. Normal-weight patients had the highest activity level (mean UCLA activity scale score [and standard deviation], 5.5 ± 2.0 points), and obese patients had the lowest (mean UCLA activity scale score, 5.0 ± 1.7 points). When adjusted for activity, cementing quality, and patient age and sex, the risk of osteolysis in obese patients was not increased as compared with that for overweight patients (adjusted odds ratio, 1.4; 95% confidence interval, 0.6 to 3.7), whereas the risk of femoral osteolysis in normal-weight patients was found to be significantly higher than that in overweight patients (adjusted odds ratio, 2.6; 95% confidence interval, 1.2 to 5.7). Clinical outcomes were similar among the groups. Conclusions: We found no increased risk of osteolysis around a cemented femoral stem in obese patients five and ten years after primary total hip arthroplasty. The highest prevalence of osteolysis was observed in normal-weight patients.
ACCESSION #
53494679

 

Related Articles

  • Morbid Obesity: A Significant Risk Factor for Failure of Two-Stage Revision Total Hip Arthroplasty for Infection. Houdek, Matthew T.; Wagner, Eric R.; Watts, Chad D.; Osmon, Douglas R.; Hanssen, Arlen D.; Lewallen, David G.; Mabry, Tad M. // Journal of Bone & Joint Surgery, American Volume;2/18/2015, Vol. 97 Issue 4, p326 

    Background: Morbid obesity (BMI [body mass index], ⩾40 kg/m2) is associated with a higher risk of complications, including infection and implant failure, following primary total hip arthroplasty. The purpose of this study was to compare the results of two-stage revision total hip...

  • Weight Changes After Total Hip or Knee Arthroplasty. Ast, Michael P.; Abdel, Matthew P.; Yuo-yu Lee; Lyman, Stephen; Ruel, Allison V.; Westrich, Geoffrey H. // Journal of Bone & Joint Surgery, American Volume;6/3/2015, Vol. 97 Issue 11, p911 

    Background: Conflicting evidence exists with regard to weight loss after total hip arthroplasty or total knee arthroplasty. The purposes of this study were to determine whether patients lose weight after total hip arthroplasty or total knee arthroplasty, whether there are predictors of weight...

  • Retention of a Well-Fixed Acetabular Component in the Setting of Massive Acetabular Osteolysis and Pelvic Discontinuity A: Case Report. Pekmezci, Murat; Keeney, James; Schutz, Amanda; Clohisy, John C. // Journal of Bone & Joint Surgery, American Volume;Sep2009, Vol. 91-A Issue 9, p2232 

    The article presents a case study about a sixty-one-year-old woman with a right-sided pain nine years after a right primary total hip arthroplasty. She states that the pain was getting worse with activity and improved with rest. She also had a history of cholecystectomy, hernia repairs and right...

  • CORR Insights(®): frequent femoral neck osteolysis with Birmingham mid-head resection resurfacing arthroplasty in young patients. Mont, Michael; Cherian, Jeffrey; Mont, Michael A; Cherian, Jeffrey J // Clinical Orthopaedics & Related Research;Dec2015, Vol. 473 Issue 12, p3779 

    The author discusses the study regarding frequent femoral neck osteolysis with resection resurfacing arthroplasty in young patients. Topics discussed include the mid-head resection resurfacing as an alternative to conventional hip arthroplasty implants, prostheses which is associated with high...

  • Relationship of body mass index to early complications in hip replacement surgery. Patel, A.; Albrizio, M. // International Orthopaedics;Aug2007, Vol. 31 Issue 4, p439 

    The purpose of this study was to evaluate the relationship between body mass index and early complications following total hip replacements. Five hundred and fifty patients who underwent primary total hip replacement were recruited. All these patients were subjected to a pre-operative assessment...

  • Metal-on-Metal Hip Resurfacing for Obese Patients. Le Duff, Michel J.; Amstutz, Harlan C.; Dorey, Frederick J. // Journal of Bone & Joint Surgery, American Volume;Dec2007, Vol. 89-A Issue 12, p2705 

    Background: The effect of obesity on the outcomes of metal-on-metal resurfacing arthroplasty is not currently known. In this study, we assessed the influence of body mass index on the survival of a metal-on-metal hybrid hip resurfacing prosthesis by comparing the clinical results of patients...

  • Primary Total Hip Arthroplasty with a Proximally Porous-Coated Femoral Stem. Sinha, Raj K.; Dungy, Danton S.; Yeon, Howard B. // Journal of Bone & Joint Surgery, American Volume;Jun2004, Vol. 86-A Issue 6, p1254 

    The use of cementless, proximally porous-coated femoral stems for total hip arthroplasty has increased in popularity. The purpose of the present report was to examine the five to ten-year results associated with the use of a so-called second-generation circumferentially proximally porous-coated...

  • Mid term results of total hip arthroplasty using polyethylene-ceramic composite (Sandwich) liner. Tao Wang; Jun-Ying Sun; Guo-Chun Zha; Sheng-Jie Dong; Xi-Jiang Zhao // Indian Journal of Orthopaedics;Jan/Feb2016, Vol. 50 Issue 1, p10 

    Background: Ceramic-on-ceramic (COC) couplings are an attractive alternative bearing surfaces that have been reported to eliminate or reduce problems related to polyethylene wear debris. However, the material in total hip arthroplasty (THA) remains one of the major concern regarding the risk of...

  • Complete acetabular cup revision versus isolated liner exchange for polyethylene wear and osteolysis without loosening in cementless total hip arthroplasty. Koh, Kyoung; Moon, Young-Wan; Lim, Seung-Jae; Lee, Hyun; Shim, Jae; Park, Youn-Soo // Archives of Orthopaedic & Trauma Surgery;Nov2011, Vol. 131 Issue 11, p1591 

    Introduction: Revision surgery in patients showing polyethylene wear and acetabular osteolysis without visible acetabular cup loosening involves the difficult decision of whether to revise only the liner or both the cup and the liner. The purpose of this study is to compare the outcomes of...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics