术前肥胖对髋关节置换术后翻修率的影响

The impact of pre-operative obesity on the rate of revision total hip arthroplasy

目的探讨髋关节置换术前肥胖对术后翻修率的影响。方法选取于本院2009年1月至2018年1月本院行初次髋关节置换术患者451例,根据患者的体重指数(body mass index,BMI)分为对照组(BMI<30 kg/m2)315例和肥胖组(BMI≥30 kg/m2)136例。分析比较两组患者行髋关节置换术后翻修率。结果肥胖组患者行髋关节置换术后翻修率明显高于对照组(23.5%vs.9.5%,P<0.05);对照组中行翻修术的主要原因为无菌性松动(3.8%)和感染(3.1%),而肥胖组的主要原因为无菌性松动(8.0%)和假体周围骨折(5.1%)。肥胖组假体周围骨折和脱位的比例均高于对照组(5.1%vs.0.9%,2.9%vs.0.3%,P<0.05)。结论髋关节置换术前肥胖提高了翻修的风险,主要的翻修原因为无菌性松动和假体周围骨折。

Objective To explore the impact of pre-operative obesity on the rate of revision total hip arthroplasty and etiology.Methods 451 patients who undergoing primary total hip arthroplasty were analyzed from January 2009 to January 2018 in our hospital.According to body mass index(BMI),315 patients were assigned to control group(BMI<30 kg/m2)and 136 patiens were assigned to obesity group(BMI≥30 kg/m2).The rate of revision total hip arthroplasty and etiology between these two groups were analyzed and compared.Results The rate of revision total hip arthroplasty in obesity group was increased compared with control group(23.5%vs.9.5%,P<0.05).The etiologies of revision total hip arthroplasty in control group were aseptic loosening(3.8%)and infection(3.1%),and they were aseptic loosening(8.0%)and periprosthetic fracture(5.1%)in obesity group.The rates of periprosthetic fracture and dislocation were increased in obesity group(5.1%vs.0.9%,2.9%vs.0.3%,P<0.05).Conclusion The rate of revision total hip arthroplasty was increased in patients with pre-operative obesity,and the main etiologies were aseptic loosening and periprosthetic fracture.