Berkovich Yaron, Rosenberg Lahav, Fournier Linor, Steinfeld Yaniv, Maman David
Orthopedic Department, Carmel Medical Center, Haifa 3436212, Israel.
The Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa 2611001, Israel.
Healthcare (Basel). 2025 Apr 12;13(8):887. doi: 10.3390/healthcare13080887.
THA is a widely performed surgical procedure that improves mobility and quality of life in patients with hip joint diseases. The increasing prevalence of obesity has led to a rise in the number of patients undergoing THA following bariatric surgery. This study investigates trends in THA among patients with a history of bariatric surgery, comparing demographics, hospitalization metrics, post-operative complications, and overall surgical outcomes to those without such history.
Using the NIS database (2016-2019), we analyzed a cohort of 1,496,809 THA patients, including 20,429 with a history of bariatric surgery. Propensity score matching was employed to control for confounding factors, resulting in a matched cohort of 20,429 patients in each group. Statistical analyses compared demographic characteristics, comorbidities, hospitalization outcomes, and post-operative complications, with a significance threshold of < 0.05.
The proportion of THA patients with prior bariatric surgery increased significantly between 2016 and 2019 ( < 0.01). Compared to those without a history of bariatric surgery, these patients were younger (60.3 vs. 66.0 years, < 0.01) and predominantly female (75.0% vs. 55.5%, < 0.01). After PSM, patients with a history of bariatric surgery had a shorter hospital stay (2.17 vs. 2.37 days, = 0.027) but incurred higher hospital charges ($63,631 vs. $62,883, < 0.01). Post-operative complications were significantly higher in this group, with increased risks of hip dislocation (RR = 4.0, 95% CI: 3.4-4.8, < 0.01), surgical site infection (RR = 2.0, 95% CI: 1.8-2.4, < 0.01), pneumonia (RR = 2.5, 95% CI: 2.1-2.8, < 0.01), and intraoperative fracture (RR = 1.6, 95% CI: 1.3-2.0, < 0.01).
The rising prevalence of THA in post-bariatric surgery patients highlights the need for optimized perioperative care. Despite shorter hospital stays, these patients face higher complication risks, requiring tailored management. Further research should explore alternative weight management strategies to improve outcomes.
全髋关节置换术（THA）是一种广泛开展的外科手术，可改善髋关节疾病患者的活动能力和生活质量。肥胖症患病率的上升导致接受减肥手术后进行全髋关节置换术的患者数量增加。本研究调查了有减肥手术史患者的全髋关节置换术趋势，将人口统计学、住院指标、术后并发症和总体手术结果与无此类病史的患者进行比较。
利用国家住院样本数据库（2016 - 2019年），我们分析了1,496,809例全髋关节置换术患者的队列，其中包括20,429例有减肥手术史的患者。采用倾向评分匹配法控制混杂因素，每组最终形成20,429例匹配队列。统计分析比较了人口统计学特征、合并症、住院结局和术后并发症，显著性阈值设定为<0.05。
2016年至2019年间，有减肥手术史的全髋关节置换术患者比例显著增加（<0.01）。与无减肥手术史的患者相比，这些患者更年轻（60.3岁对66.0岁，<0.01），且以女性为主（75.0%对55.5%，<0.01）。倾向评分匹配后，有减肥手术史的患者住院时间较短（2.17天对2.37天，P = 0.027），但住院费用较高（63,631美元对62,883美元，<0.01）。该组术后并发症显著更高，髋关节脱位风险增加（相对危险度RR = 4.0，95%可信区间CI：3.4 - 4.8，<0.01）、手术部位感染（RR = 2.0，95% CI：1.8 - 2.4，<0.01）、肺炎（RR = 2.5，95% CI：2.1 - 2.8，<0.01）和术中骨折（RR = 1.6，95% CI：1.3 - 2.0，<0.01）。
减肥手术后患者中全髋关节置换术患病率的上升凸显了优化围手术期护理的必要性。尽管住院时间较短，但这些患者面临更高的并发症风险，需要进行针对性管理。进一步的研究应探索其他体重管理策略以改善治疗效果。
