Obesity is a Major Risk Factor for Prosthetic Infection after Primary Hip ArthroplastyDowsey, Michelle M., RN, BApplSc1,2; Choong, Peter F. M., MBBS, MD, FRACS, FAOrthA1,2,a
The incidence of obesity and the number of hip arthroplasties being performed in Australia each year are increasing. Although uncommon, periprosthetic infection after surgery can have a devastating effect on patient outcomes. We therefore asked whether obesity correlated with periprosthetic infection after primary hip arthroplasty. We further asked whether variables such as patient comorbidities, operative time, blood transfusions, use of drains, and cementation practices correlated with periprosthetic infection. We hypothesized obesity was an independent risk factor for the development of acute periprosthetic infection after primary hip arthroplasty. We reviewed 1207 consecutive primary hip arthroplasties separating patients into four weight groups, normal, overweight, obese, and morbidly obese, and compared for incidence of periprosthetic infection between the groups. We observed a considerably higher infection rate in obese patients; the correlation was independent of patient comorbidities such as diabetes and cardiovascular disease. We also observed a correlation between infection rates and using a posterior approach in obese patients. The incidence of periprosthetic infection was not influenced by operative time, transfusion requirements, use of drains, and cementation practices. In this series, obesity was an independent risk factor for acute periprosthetic infection after primary hip arthroplasty.
Level of Evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.