全髋关节置换术前的肥胖状态对术后远期翻修率的影响

The impact of pre-operative obesity state on long-term revision rate after primary total hip arthroplasty

目的探讨全髋关节置换术(total hip arthroplasty,THA)前的肥胖状态对术后远期翻修率的影响。方法回顾性分析2004年1月~2005年12月在北京市平谷区医院行THA的患者418例,其中男性262例,女性156例,以术前体质量指数(body mass index,BMI)将患者分为肥胖组(BMI≥30 kg/m2)和非肥胖组(BMI<30 kg/m2),比较两组患者THA术后远期翻修情况的差异。结果肥胖组和非肥胖组患者THA术后5年人工关节翻修率分别为5.4%和3.1%,两组间差异无统计学意义(P>0.05);肥胖组和非肥胖组患者THA术后10年人工关节翻修率分别为15.5%和8.0%,两组间差异有统计学意义(P<0.05)。THA术后10年,肥胖组患者的翻修风险是非肥胖组患者的2.12倍(OR=2.12,95%CI为1.13~3.98);肥胖组患者因髋臼和(或)股骨假体松动而行翻修手术的风险是非肥胖组患者的2.63倍(OR=2.63,95%CI为1.03~6.77)。结论 THA术前肥胖会增加术后远期翻修率。

Objective Objective To study the impact of pre-operative obesity state on long-term revision rate after primary total hip arthroplasty. Methods 418 patients were enrolled in this retrospective study, including 262 males and 156 females. All the patients underwent primary total hip arthroplasty（THA） in Beijing Pinggu hospital from January 2014 to December 2015. The patients were divided into obesity group（BMI ≥ 30 kg/m2） and non obese group（BMI 30 kg/m2） according to the preoperative body mass index（BMI）. The difference of long-term revision after THA between the two groups was compared. Results The percentage of revision after THA at 5 years was 5.4% for obese group and 3.1% for non-obese group,there was no significant difference between the two groups（P 〈0.05）. The percentage of revision after THA revised at 10 years was 15.5% for obese group and 8.0% for nonobese group,the difference between the two groups was significant（P〈0.05）. 10 years after primary THA,compared to non-obese patients, the risk of revision in obese patients was increased by 112 percent（OR = 2.12,95%CI,1.13 ～ 3.98）, and the risk of revision due to aseptic loosening in obese patients was increased by 163 percent（OR = 2.63,95%CI,1.03 ～ 6.77）. Conclusion Pre-operative obesity can increase the risk of long-term revision THA.