Joint Replacement Surgery in the Obese Has Low Complication Rates

A new study has found that joint replacement surgery complication rates in obese patients are low, supporting those in favor of doing the procedures even in the heaviest patients; hospital stays, however, were found to be longer in the obese.

Researchers at the University of Michigan (Ann Arbor, USA) and the Hospital for Special Surgery (HSS; New York, NY, USA) conducted a review of 211 knee and 147 hip replacement surgeries performed between January 1, 2008, and December 31, 2009, by a single surgeon at the HSS. Complication rates were examined in those with a body mass index (BMI) of 30 kg/m2 or higher; a total of 136 (72%) of the knee procedures and 49 (34%) of the hip procedures involved patients who were obese; overall, 56% of the replacement procedures involved obese patients. The patients were examined for pulmonary embolism (PE), deep vein thrombosis (DVT), wound drainage, blood transfusions, infections, and length of stay in the hospital.

The researchers found that there were only four cases of PE's and DVT's, and they were all in the knee replacement group. There were six cases of wound drainage in the knee group and five in the hip group, and there was one superficial infection in the knee group, with none in the hip group. The only area where a difference was noted in the obese patient group was the length of hospital stay, which averaged 5.2 days in the knee group and 4.2 days in the hip group, compared to the average hospital stay for these replacement procedures of just 3 days. The results of the study were presented as a poster session at the National Medical Association 2010 annual convention and scientific assembly, held during July-August 2010, in Orlando (FL, USA).

"There was really a surprisingly high incidence of obesity in the joint replacement patients,” said coauthor Denise Asafu-Adjei, a medical student at the University of Michigan. "But complications were not particularly high. . . . We expected that, across the board, they would be pretty high.”

"I have almost the same profile; half the people I operate on in this category are considered obese. But we do them routinely and we have just great results, almost indistinguishable from small people,” commented William Long, M.D., a surgeon who performs joint replacement procedures at Good Samaritan Hospital (Los Angeles, CA, USA), who said the results of the HSS study dovetail with his own experience with obese patients. "Now we know the best thing we can do to save their lives is fix them. If you can get them walking again, you're going to save their lives.”

Related Links:
University of Michigan
Hospital for Special Surgery