Sharma Anirudh, Verghese Sumant Chacko, Bindumadhavan Santosh, Killampalli Jayteja, Killampalli Vijay Vardhan
Trauma & Orthopaedics, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.
Trauma & Orthopaedics, Hinchingbrooke Hospital, North-West Anglia NHS Foundation Trust, Huntingdon, UK.
Indian J Orthop. 2024 Nov 22;59(1):77-83. doi: 10.1007/s43465-024-01287-0. eCollection 2025 Jan.
Obesity has been consistently proven to be associated with an increased risk of dislocation following total hip arthroplasty (THA). As the prevalence of obesity continues to rise globally, it is of vital importance to minimise risks, including dislocation rates, in these patients undergoing THA.
We describe a series of patients with obesity, morbid obesity (BMI ≥ 40) and super-obesity (BMI ≥ 50) undergoing THA at our institution over a 10-year period using a dual-mobility acetabular cup. The dislocation rate and all-cause revision rate were used as primary outcome measures. Patient-reported outcomes (PROMS) were assessed using the Oxford hip score (OHS) and VAS score. We assessed for differences in PROMS after grouping patients into BMI ranges of 30-34.9, 35-39.9, 40-49.9 and > 50.
A total of 180 dual-mobility THAs in 162 patients were included of which 36 hips had BMI ≥ 40 and 8 hips had BMI ≥ 50. The mean age was 64.2 (29-88) years and the mean follow-up period was 52.1 months (13-122 months). The all-cause revision rate was 2.2% and no patient had a post-operative dislocation. The survivorship of the acetabular component was 100% with the maximum follow-up being 10.1 years. The mean OHS was 43.82 ± 3.29 (30-48) and the mean VAS for pain from the hip was 0.94 ± 1.34 (0-8). No significant difference in PROMS was found between the four BMI ranges.
Our results indicate excellent mid-term survivorship, and improvement over traditional dislocation rates in high BMI patients with a dual-mobility THA.
肥胖一直被证明与全髋关节置换术（THA）后脱位风险增加有关。随着全球肥胖患病率持续上升，对于这些接受THA的患者，将包括脱位率在内的风险降至最低至关重要。
我们描述了在10年期间于我们机构使用双动髋臼杯接受THA的一系列肥胖、病态肥胖（BMI≥40）和超级肥胖（BMI≥50）患者。脱位率和全因翻修率用作主要结局指标。使用牛津髋关节评分（OHS）和视觉模拟评分（VAS）评估患者报告结局（PROMS）。我们将患者按BMI范围分为30 - 34.9、35 - 39.9、40 - 49.9和>50后，评估PROMS的差异。
共纳入162例患者的180例双动THA，其中36例髋关节BMI≥40，8例髋关节BMI≥50。平均年龄为64.2（29 - 88）岁，平均随访期为52.1个月（13 - 122个月）。全因翻修率为2.2%，无患者术后脱位。髋臼组件的生存率为100%，最长随访时间为10.1年。平均OHS为43.82±3.29（30 - 48），髋关节疼痛的平均VAS为0.94±1.34（0 - 8）。在四个BMI范围内未发现PROMS有显著差异。
我们的结果表明，对于高BMI患者采用双动THA，中期生存率良好，且优于传统脱位率。
