Bariatric & THA

Bariatric Surgery Improves Total Hip Arthroplasty Outcomes In Patients With Obesity: A National Cohort Study With 6 Years of Follow-Up

Importance: Obesity is a risk factor for end stage hip osteoarthritis, and Total Hip Arthroplasty (THA) is commonly performed to reduce pain and improve functionality. However, obesity has been associated with increased risk of complications after THA. Although bariatric surgery may also be utilized to reduce weight, the impacts of bariatric surgery on THA outcomes remains inadequately understood.  

Objective: To investigate the effect of bariatric surgery on outcomes of THA in obese patients. 

Design, Setting and Participants: A retrospective cohort analysis utilizing multicenter EMR data ranging from 2003 to 2023. Patients with obesity who underwent THA were stratified based on whether they had bariatric surgery prior. The final bariatric cohort comprised 451 patients after propensity score matching. 

Main Outcomes and Measures: Complication rates and revision risks were compared between cohorts.

Results: At 6 months follow-up, the bariatric cohort had significantly lower risks of surgical site infection, wound dehiscence, and deep vein thrombosis. At 6 years follow-up,  the bariatric cohort demonstrated reduced rates of revision, mortality, pulmonary embolism, and Clavien-Dindo grade IV complications.

Conclusion and Relevance: This study suggests bariatric surgery prior to THA may reduce complication risks in obese patients.  

Key Words: obesity, bariatric, gastric bypass, revision, hip arthroplasty, complications,  risk reduction, weight loss, population-based study, national cohort.