Department of Orthopaedics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
J Arthroplasty. 2012 Mar;27(3):391-6. doi: 10.1016/j.arth.2011.05.012. Epub 2011 Jul 28.
Obesity is considered an independent risk factor for adverse outcome after arthroplasty surgery. Data on 191 consecutive total hip arthroplasties were prospectively collected. Body mass index (BMI) was calculated for each patient and grouped into nonobese (BMI <30 kg/m(2)), obese (BMI 30-34.9 kg/m(2)), and morbidly obese (BMI ≥35 kg/m(2)). Primary outcomes included functional improvement (Oxford hip score, 6-minute walk test and Short Form-12 Health Survey general health questionnaire) and postoperative complications. Subgroup analysis of surgeons' overall perception of operative technical difficulty was also performed. This study shows that total hip arthroplasties in obese patients were perceived, by the surgeon, to be significantly more difficult. However, this did not translate to an increased risk of complications, operation time, or blood loss, nor suboptimal implant placement. In addition, our results suggest that obese patients gain similar benefit from hip arthroplasty as do nonobese patients, but morbidly obese patients have significantly worse 6-minute walk test scores at 6 weeks.
肥胖被认为是关节置换手术后不良结果的独立危险因素。前瞻性收集了 191 例连续全髋关节置换术的数据。为每位患者计算了体重指数（BMI），并将其分为非肥胖组（BMI＜30kg/m²）、肥胖组（BMI 30-34.9kg/m²）和病态肥胖组（BMI≥35kg/m²）。主要结果包括功能改善（牛津髋关节评分、6 分钟步行试验和 12 项简明健康调查问卷一般健康问卷）和术后并发症。还对手术医生对手术技术难度的整体感知进行了亚组分析。本研究表明，肥胖患者的全髋关节置换术被医生认为明显更具难度。然而，这并没有增加并发症、手术时间或失血量的风险，也没有导致植入物位置不佳。此外，我们的结果表明，肥胖患者从髋关节置换术中获得的益处与非肥胖患者相似，但病态肥胖患者在 6 周时的 6 分钟步行试验评分明显更差。
