Early outcomes and complications following joint arthroplasty in obese patients: A review of the published reports

The incidence of obesity and the number of hip arthroplasties being carried out in Australia each year are significantly increasing. There is an overrepresentation of obesity among patients presenting for elective orthopaedic surgery. The aim of this study was to present a review of published works reporting on obesity and joint replacement surgery in terms of early clinical, functional and quality-of-life outcomes. We conducted a metasearch of databases, including PubMed, Web of Science and The Cochrane Library, from January 1990 to May 2007. Studies published in English with a primary intention of exploring the relationship between obesity and joint arthroplasty were reviewed and results summarized. Key issues identified in relation to obesity and joint replacement surgery included clinical outcomes and complications, functional and quality of life and the influence of arthroplasty surgery on the management of obesity. Reports on early outcomes, that is in the first 12 months following joint replacement surgery, were included in the review. Results for these three key issues were summarized and reported separately. There is evidence in the published reports to support a correlation between obesity and complications following joint replacement surgery. Obesity has been found to be a specific risk factor for joint infection. Research on early functional and quality-of-life data as well as on the influence arthroplasty surgery has on weight management is lacking, and few conclusions can be drawn from the published reports. A study of significant size that examines all three issues in conjunction would be of value in identifying patients at high risk of failure in terms of both clinical and quality-of-life perspectives.