Here is an interesting article about the effects of obesity on the outcome of hip replacement surgery. Many patients who undergo surgery are somewhat overweight, but this isn’t a reason not to have it. Please get in touch if you would like to know more.

Opinion remains divided regarding the implications of obesity on cost, complications and outcomes following total hip replacement. With the literature as divided as surgeons are on the relative risks and implications of the ‘superobese’, it is difficult to know exactly where the truth lies. We were heartened to read this simple but comprehensive analysis from the US of a retrospective of fairly sizeable numbers which is able to stratify patients into different grades of obesity. The statistical analysis compares 377 000 patients with ‘normal’ BMI against 9900 who were morbidly obese and 800 ‘superobese’ patients (BMI > 50) in one of the first analyses to be able to account in significant numbers for the superobese. The authors conclude that in those patients with a BMI over 40, there is an increased risk of infection, and in the number of complications. Interestingly, the excess complication burden includes both surgical and medical complications and is especially pronounced in those with BMI > 50. The data here clearly come down in support of a school of thought that increased BMI is associated with higher rates of complication and re-admission. The difficulty with papers like this is that healthcare insurers and providers will often use them as an excuse to deny surgery to obese patients. However, the health economic decision is obviously much more complex than this. What this paper does clearly establish, given the large numbers, is that there is an excess in complications significant enough to warrant a mention during the pre-operative counselling process.

Meller MM et al: Surgical risks and costs of care are greater in patients who are super obese and undergoing THA. Clin Orthop Relat Res 2016;474:2472-2481