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Meta-Analysis
. 2011 Aug;82(4):417-22.
doi: 10.3109/17453674.2011.588859. Epub 2011 Jun 10.

Obesity in total hip arthroplasty--does it really matter? A meta-analysis

Daniël Haverkamp  1 , Mark N Klinkenbijl, Mathijs P Somford, G H Rob Albers, Harm M van der Vis
Affiliations
Meta-Analysis

Obesity in total hip arthroplasty--does it really matter? A meta-analysis

Daniël Haverkamp et al. Acta Orthop. 2011 Aug.

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 I(2) 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 (I(2) = 68%).

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

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Figures

Figure 1.
Figure 1.
PRISMA flow diagram.
Figure 2.
Figure 2.
Forest plot, dislocations
Figure 3.
Figure 3.
Forest plot, septic loosening.
Figure 4.
Figure 4.
Forest plot, aseptic loosening.
Figure 5.
Figure 5.
Forrest plot, Harris hip score.
Figure 6.
Figure 6.
Forest plot, infection.
Figure 7.
Figure 7.
Forest plot, hematoma.
Figure 8.
Figure 8.
Forest plot, venous thromboembolism.
Figure 9.
Figure 9.
Forest plot, perioperative fracture.
See this image and copyright information in PMC

Comment in

References

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