gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie, 75. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 97. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 52. Tagung des Berufsverbandes der Fachärzte für Orthopädie und Unfallchirurgie

25. - 28.10.2011, Berlin

Comparison of implant position and early functional outcome of minimally invasive hip arthroplasty in obese and non-obese patients

Meeting Abstract

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  • R. Schuh - Medizinische Universität Innsbruck, Univ.-Klinik f. Orthopädie, Innsbruck, Austria
  • M. Hungerford - JointExperience, Johns Hopkins Orthopaedics at Good Samarita, Baltimore, United States

Deutscher Kongress für Orthopädie und Unfallchirurgie. 75. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 97. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 52. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 25.-28.10.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocWI52-1619

DOI: 10.3205/11dkou318, URN: urn:nbn:de:0183-11dkou3182

Veröffentlicht: 18. Oktober 2011

© 2011 Schuh et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Questionnaire: Total hip arthroplasty continues to be one of the most successful orthopaedic procedures. A great deal of attention in recent years has been focused on alternate and improved approaches to minimize soft tissue dissection and surgical trauma. Obesity has been cited by some authors as a contraindication to minimally invasive joint surgery.

The aim of the present study is to determine whether there are any differences in the implant position and early functional outcome of total hip arthroplasty between obese and non-obese patients.

Methods: A series of 122 consecutive patients who had 136 primary total hip arthroplasty surgeries done through an anterior approach by a single surgeon from November 2005 to July 2008 was reviewed. The patients were categorized into three groups: non-obese (body mass index (BMI) <25 kg/m2), overweight (BMI 25-30 kg/m2) and obese (BMI>30 kg/m2).The outcome measure included radiological analysis assessing cup position and leg length discrepancy, modified Harris Hip Score, operative time and estimated blood loss. Radiological analysis and modified Harris Hip Score were routinely performed at 6 weeks after surgery. Presurgically, there was no significant difference of age as well as Harris Hip Score (HHS) between the groups.

Results and Conclusions: 37 patients were assigned to the non-obese group (group 1), 42 patients to the overweight group (group 2) and 43 to the obese group (group 3). Mean abduction angle was 49,4­3°±5,1° in group 2, 48,3°±5,6° in group 3 and 47,2°±5,6° in group 1. The average anteversion was 16,5°±5,5° in group 2, 18,6°±5,8° in group 1 and 17,5°± 4,7° in group 3. In group 1 leg length discrepancy was on average 3,6± 3,4 mm, in group 2 it was 4,3±7,5 mm and in group 3 it was 3,8 ±3,1 mm. Mean operative time was 110,5±30,6 min in group 2, 115,5±23,2 min in group 3 and 101,4 ±17,4 min in group 1. The average estimated blood loss was 522,9±323,9 ml in group 2, 501,7±288,8 ml in group 3 and 461,7±317,7 ml in group 1. The mean hospital stay was 2,9±0,8 days in group 1, 2,8±0,6 days in group 2 and 3,2±2,0 days in group 3. 6 weeks postsurgically mean modified HHS was 83,7±11,0 in group 1, 83,4±14,0 in group 2 and 85,2±11,3. Student's t-test revealed no statistical difference significance between any of those groups (p<0,05).

The results of the present study show that a single anterior approach allows accurate and reproducible component positioning and leg-length restoration in non-obese as well as obese patients. Our findings suggest that there is no evidence to support withholding total hip replacement from obese patients on the ground that their implant position and early functional outcome will be less satisfactory than those who are not obese.