Is there a correlation of obesity and complications following  Joint Replacement Surgery?

Is there a correlation of obesity and complications following  Joint Replacement Surgery?

Post-Operative Outcomes

Obesity is linked to longer hospital stays for added care and monitoring following surgery. On average, obese patients tend to remain hospitalized longer than their non-obese counterparts and are more likely to be referred to a rehabilitation centre instead of returning home. Research also indicates that obesity is associated with higher rates of readmission after total joint replacement procedures. Additionally, obese individuals may require different or extra medications compared to those who are not obese.

Complications

Research shows that obesity significantly elevates the risk of experiencing medical or surgical complications, including:

1. Increased soft tissue depth, which complicates the positioning of implants during surgery.
2. Greater likelihood of wound complications, such as hematomas.
3. Increased risk of infection.
4. Increased chances of total hip arthroplasty (THA) dislocation due to soft tissue impingement or the joint being displaced.

Consequently, achieving an optimal Body Mass Index (BMI) is crucial prior to undergoing hip or knee replacement surgery. Moreover, individuals with obesity often face additional medical comorbidities—multiple health conditions occurring simultaneously—such as diabetes, cardiovascular disease, metabolic syndrome, malnutrition, and obstructive sleep apnoea. Each of these conditions independently increases surgical risks, meaning that an obese patient with one or more comorbidities faces an even higher risk of complications

References:

1. Boyce L, et all. The outcomes of total knee arthroplasty in morbidly obese patients: a systematic review of the literature. Arch Orthop Trauma Surg. 2019 Apr;139(4):553-560. doi: 10.1007/s00402-019-03127-5. Epub 2019 Feb 16. PMID: 30778723; PMCID: PMC6420900.
2. Schwartz FH, et al. Factors That Affect Outcome Following Total Joint Arthroplasty: a Review of the Recent Literature. Curr Rev Musculoskelet Med. 2017 Sep;10(3):346-355. doi: 10.1007/s12178-017-9421-8. PMID: 28664450; PMCID: PMC5577422.
3. Li, T., et al. Risk factors associated with surgical site infections following joint replacement surgery: a narrative review. Arthroplasty 4, 11 (2022). https://doi.org/10.1186/s42836-022-00113-y
4. Antonelli, B., Chen, A.F. Reducing the risk of infection after total joint arthroplasty: preoperative optimization. Arthroplasty 1, 4 (2019). https://doi.org/10.1186/s42836-019-0003-7
5. Berstock JR, et al. Mortality after total hip replacement surgery. Bone Joint Res. 2014;3(6):175-182. doi:10.1302/2046-3758.36.200023