Department of Orthopedics, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.
Obes Surg. 2012 Apr;22(4):523-9. doi: 10.1007/s11695-011-0483-1.
Overweight/obesity in patients after total hip arthroplasty (THA) is a growing problem and is associated with postoperative complications and a negative effect on functional outcome. The objective of this study is to determine to what extent overweight/obesity is associated with physical functioning and health-related quality of life 1 year after primary THA.
A retrospective analysis of prospectively collected data from 653 patients who had undergone a primary THA was conducted. Physical functioning, health-related quality of life, body mass index (BMI), comorbidity, and postoperative complications were assessed by means of a questionnaire and from medical records. To determine to what extent overweight/obesity is associated with physical functioning and health-related quality of life after THA, a structural equation model (SEM) analysis was conducted.
The association of BMI corrected for age, gender, complications, and comorbidity with physical functioning is -0.63. This means that an increase in 1 kg/m2 BMI leads to a reduction of 0.63 points in the physical functioning score as measured with the Western Ontario and McMaster Universities Osteoarthritis Index (100-point scale). The prevalence of complications or comorbidity leads to a reduction of, respectively, 5.63 and 7.25 (one or two comorbidities) and 14.50 points in the case of more than two comorbidities on the physical functioning score. The same pattern is observed for health-related quality of life.
The influence of overweight/obesity on physical functioning and health-related quality of life is low. The impact of complications and comorbidity is considerable. Refusing a patient a THA solely on the basis of overweight or obesity does not seem justified.
全髋关节置换术后（THA）患者超重/肥胖是一个日益严重的问题，与术后并发症和对功能结果的负面影响有关。本研究的目的是确定超重/肥胖与初次 THA 后 1 年的身体机能和健康相关生活质量的关联程度。
对 653 例行初次 THA 的患者前瞻性收集的数据进行回顾性分析。通过问卷调查和病历评估身体机能、健康相关生活质量、体重指数（BMI）、合并症和术后并发症。为了确定超重/肥胖与 THA 后身体机能和健康相关生活质量的关联程度，进行了结构方程模型（SEM）分析。
BMI 经年龄、性别、并发症和合并症校正后与身体机能的相关性为-0.63。这意味着 BMI 增加 1kg/m2，Western Ontario 和 McMaster 大学骨关节炎指数（100 分制）的身体机能评分就会降低 0.63 分。并发症或合并症的发生率分别导致身体机能评分降低 5.63 分和 7.25 分（有 1 或 2 种合并症）和 14.50 分（有超过 2 种合并症）。健康相关生活质量也呈现出相同的模式。
超重/肥胖对身体机能和健康相关生活质量的影响较小。并发症和合并症的影响相当大。仅仅因为超重或肥胖而拒绝为患者行 THA 似乎是不合理的。
