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Hinz N, Marsoni G, Mittelstädt H, Sonnabend F, Wallroth K, Johl C, Weigert U, Anderl C, Ortmaier R, Zeleny N, Schulz AP. Short stem hip arthroplasty with the optimys prosthesis is a safe and effective option for obese patients: a mid-term follow-up multicenter study. Arch Orthop Trauma Surg 2024; 144:1401-1414. [PMID: 37924371 PMCID: PMC10896938 DOI: 10.1007/s00402-023-05105-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 10/09/2023] [Indexed: 11/06/2023]
Abstract
INTRODUCTION Short stems are a valuable option in young patients undergoing total hip arthroplasty (THA) because of their bone stock preserving properties facilitating revision hip arthroplasty. Although the effect of obesity on conventional THA is well studied, data about short stem THA in obese patients are lacking. Therefore, this study aimed to investigate the influence of obesity on complications, revisions, and outcome after short stem THA. MATERIALS AND METHODS This multicenter, observational cohort study included patients undergoing short stem THA with the optimys prosthesis. Follow-up examinations were performed at specific intervals up to 7 years postoperatively. Operation characteristics, general and specific complications, revisions, VAS rest pain, VAS load pain, VAS patient satisfaction, and Harris Hip Score (HHS) were recorded and statistically compared between obese (BMI ≥ 30 kg/m2) and non-obese (BMI < 30 kg/m2) patients. RESULTS Of the 224 patients included with a mean follow-up of 87.2 months (range 81.9-104.0), 69 were assigned to the OB group and 155 to the non-OB group. A minimally invasive approach was significantly less often selected in obese patients (p = 0.049), whereas operating time and length of hospital stay were not significantly different. The rate of general and specific complications did not significantly differ between both groups. Survival of the optimys prosthesis was 99.1% at 7-year follow-up and one patient per group had to undergo revision surgery. VAS rest pain, load pain, and satisfaction improved from preoperatively to postoperatively in both groups without a significant difference between both groups. While the HHS was improved from preoperatively to postoperatively, obese patients showed a significantly lower HHS at the 7-year follow-up (p = 0.01) but still exhibited an excellent scoring above the PASS threshold. CONCLUSION Short stem THA with the optimys prosthesis is a safe and effective option also in obese patients with an excellent clinical outcome and a low complication rate.
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Affiliation(s)
- Nico Hinz
- BG Hospital Hamburg, Trauma Surgery, Orthopedics and Sports Traumatology, Bergedorfer Strasse 10, 21033, Hamburg, Germany.
| | - Giulia Marsoni
- Erzgebirgsklinikum, Orthopedics and Trauma Surgery, Jahnsdorfer Strasse 7, 09366, Stollberg, Germany
| | - Hagen Mittelstädt
- University Medical Center Schleswig-Holstein, Campus Lübeck, Orthopaedic and Trauma Surgery, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Falk Sonnabend
- Helios Klinik Köthen, Orthopedics, Hallesche Strasse 29, 06366, Köthen, Germany
| | - Karsten Wallroth
- Erzgebirgsklinikum, Orthopedics and Trauma Surgery, Jahnsdorfer Strasse 7, 09366, Stollberg, Germany
| | - Carsten Johl
- Klinikum Dahme-Spreewald, Orthopedics and Trauma Surgery, Schillerstrasse 29, 15907, Lübben, Germany
| | - Ulrich Weigert
- Practice for Orthopedics and Trauma Surgery, Friedrichstrasse 1-3, 15537, Erkner, Germany
| | - Conrad Anderl
- Ordensklinikum Linz Barmherzige Schwestern, Orthopedics, Seilerstätte 4, 4010, Linz, Austria
| | - Reinhold Ortmaier
- Ordensklinikum Linz Barmherzige Schwestern, Orthopedics, Seilerstätte 4, 4010, Linz, Austria
| | | | - Arndt-Peter Schulz
- BG Hospital Hamburg, Trauma Surgery, Orthopedics and Sports Traumatology, Bergedorfer Strasse 10, 21033, Hamburg, Germany
- Medical Faculty, Universität zu Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
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Lin YS, DeClercq JJ, Ayers GD, Gilmor RJ, Collett G, Jain NB. Incidence and Clinical Risk Factors of Post-Operative Complications following Primary Total Hip Arthroplasty: A 10-Year Population-Based Cohort Study. J Clin Med 2023; 13:160. [PMID: 38202167 PMCID: PMC10780046 DOI: 10.3390/jcm13010160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 12/19/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024] Open
Abstract
Background: Total hip arthroplasty (THA) has become a growing treatment procedure for debilitating hip pathologies. Patients experienced post-operative complications and revision surgeries according to large THA registries. To fully understand the short-term and long-term post-operative outcomes following THA, the purpose of this study is to examine the incidence of post-operative complications following primary THA and to examine how this trend has changed over 10 years within community hospitals in the US using large databases. Methods: This study queried the State Inpatient Database (SID) for primary THA between 2006 and 2015. Individual patients were followed forward in time until the first instance of a post-operative complication. The multivariable logistic regression analyses were computed to examine which post-operative complications were independent predictors of pre-operative comorbidities. Results: Median age of patients was 67 years, and 56% of patients were female. Females with avascular necrosis (AVN) as an indication for THA had a 27% higher risk of complication. Females with osteoarthritis (OA) as an indication for THA had a 6% higher risk of complication. Post-operative complications occurred with higher frequencies in the first two months of THA and the highest risks of THA complications within the first 6 months. Conclusion: The most common indication is OA in elders with primary THA. Females and those of black ethnicity showed the greatest risks of THA complications. Data from our large study can be used to understand post-operative complications and readmissions after THA. Our study also provides data on risk factors associated with these complications.
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Affiliation(s)
- Yen-Sheng Lin
- Department of Orthopaedic Surgery, University of Texas Southwestern, Dallas, TX 75390, USA; (Y.-S.L.); (G.C.)
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern, Dallas, TX 75390, USA
| | - Joshua J. DeClercq
- Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN 37212, USA (G.D.A.)
| | - Gregory D. Ayers
- Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN 37212, USA (G.D.A.)
| | | | - Garen Collett
- Department of Orthopaedic Surgery, University of Texas Southwestern, Dallas, TX 75390, USA; (Y.-S.L.); (G.C.)
| | - Nitin B. Jain
- Department of Orthopaedic Surgery, University of Texas Southwestern, Dallas, TX 75390, USA; (Y.-S.L.); (G.C.)
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern, Dallas, TX 75390, USA
- Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN 37212, USA (G.D.A.)
- Department of Population & Data Sciences, University of Texas Southwestern, Dallas, TX 75390, USA
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