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German Congress of Orthopaedics and Traumatology (DKOU 2021)

26. - 29.10.2021, Berlin

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Obesity in short stem total hip arthroplasty using a minimally invasive supine anterolateral approach – a risk factor for short-term complications?

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  • presenting/speaker Matthias Luger - Kepler Universitätsklinikum GmbH, Med Campus III, Universitätsklinik für Orthopädie und Traumatologie, Linz, Austria
  • Rainer Hochgatterer - Kepler Universitätsklinikum GmbH, Med Campus III, Universitätsklinik für Orthopädie und Traumatologie, Linz, Austria
  • Lorenz Pisecky - Kepler Universitätsklinikum GmbH, Med Campus III, Universitätsklinik für Orthopädie und Traumatologie, Linz, Austria
  • Jakob Allerstorfer - Kepler Universitätsklinikum GmbH, Med Campus III, Universitätsklinik für Orthopädie und Traumatologie, Linz, Austria
  • Antonio Klasan - Kepler Universitätsklinikum GmbH, Med Campus III, Universitätsklinik für Orthopädie und Traumatologie, Linz, Austria
  • Tobias Gotterbarm - Kepler Universitätsklinikum GmbH, Med Campus III, Universitätsklinik für Orthopädie und Traumatologie, Linz, Austria
  • Bernhard Schauer - Kepler Universitätsklinikum GmbH, Med Campus III, Universitätsklinik für Orthopädie und Traumatologie, Linz, Austria

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2021). Berlin, 26.-29.10.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocAB28-384

doi: 10.3205/21dkou105, urn:nbn:de:0183-21dkou1058

Published: October 26, 2021

© 2021 Luger et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objectives: Obesity is associated with increased risk for surgical complications in total hip arthroplasty (THA) especially in the direct anterior approach. The impact of obesity on short-term complication in minimally invasive (MIS) anterolateral approach is not well understood. Therefore, this study was conducted to evaluate the early complications within the first 90 days after THA using a MIS anterolateral approach with a short-curved stem.

Methods: A case series of 968 THAs (index surgery 2014-2019) with a short curved stem and press fit cup (Fitmore® hip stem/ Allofit-/S® cup; both ZimmerBiomet, Warsaw, IN, USA) implanted using a MIS anterolateral approach in supine position were included and stratified by body mass index (BMI). Perioperative complications, length of stay, blood loss, reoperation, revision and readmission within 90 days after index surgery were retrospectively evaluated. Kruskal-Wallis-Test and Fisher's Exact Test were performed. Logistic regression was conducted to analyze the effects of BMI, age, gender and American Society Anesthesiologists (ASA) score on the probability of perioperative complications within 90 days after index surgery.

Results and Conclusion: Severely obese patients (BMI>35kg/m²) demonstrated a significantly increased operation time (p<0.001) and a higher risk for general surgical complications (p=0.026) (odds ratio (OR)=3.242; CI=14.17-7.116)), periprosthetic joint infection (PJI) (p=0.022) (OR=10.757; CI=2.003-57.783) and revision (OR=5.263; CI=1.405-18.963).

MIS anterolateral THA with a curved short stem is a safe treatment for obese patients. Severely obese patients are at higher risk for PJI in MIS anterolateral THA. However, the risk is similar to findings in comparable literature for other minimally invasive approaches such as DAA.