Relationship of Soft Tissue Thickness With Body Mass Index and Perioperative Factors in Patients Undergoing Total Hip Arthroplasty: A Retrospective Cross-Sectional Study

Abstract

Background Total hip arthroplasty is one of the most common elective procedures, making it crucial to minimize associated risks. The thickness of soft tissues at the surgical site is used to predict complications when evaluated individually. However, the direct relationship between soft tissue thickness, body mass index (BMI), and perioperative factors has not been established, making it necessary to determine this relationship to improve the prediction of complications using only standard radiographic measurements. The objective of this study is to determine whether there is a significant correlation between soft tissue thickness, BMI, and perioperative factors in patients who have undergone total hip arthroplasty. Methods A total of 106 records from the Orthopedics and Traumatology service at the General Hospital of Mexico "Dr. Eduardo Liceaga" were analyzed, of which 88 patients met the inclusion criteria. A retrospective, cross-sectional, observational, and descriptive study was conducted using these complete records of patients who underwent primary total hip arthroplasty from 2020 to 2023. Radiographic measurements were performed to determine soft tissue thickness using the Bernaus technique. These measurements were then compared with collected data, including weight, height, BMI, glucose levels, blood loss, and surgical time. Results In our statistical analysis, we find a moderate correlation of 0.552 between BMI and soft tissue thickness, indicating a positive association. The analysis showed that an increase in BMI is significantly associated with an increase in soft tissue thickness (p = 0.002). No significant relationship was found between soft tissue thickness and sex (p = 0.546) or age (p = 0.666). However, a significant relationship was observed between surgical time and patient age (p = 0.023), suggesting that the duration of the procedure increases with age. No significant relationships were found between surgical time and BMI, glucose, or weight. Conclusion The study confirms a significant positive association between soft tissue thickness and BMI, suggesting that greater soft tissue thickness correlates with a higher BMI. These findings highlight the importance of BMI in evaluating soft tissue thickness, which could influence surgical planning. However, soft tissue thickness shows limited association with certain perioperative factors in total hip arthroplasty patients. These findings emphasize the need for further research with more detailed variables and larger samples to validate these results and enhance recommendations for total hip arthroplasty procedures.

Keywords: bmi; hip; joint replacement; risk factors; total hip arthroplasty; total joint arthroplasty.