Abstract：
BACKGROUND: Obesity is a risk factor for end-stage hip osteoarthritis. While total hip arthroplasty (THA) is commonly performed to reduce pain and improve function associated with osteoarthritis, obesity has been associated with an increased risk of complications after THA. Although bariatric surgery may also be utilized to reduce weight, the impact of bariatric surgery on THA outcomes remains inadequately understood.
METHODS: This retrospective cohort analysis utilized multicenter electronic medical record data ranging from 2003 to 2023. Patients who have obesity who underwent THA were stratified based on prior bariatric surgery. The final bariatric cohort comprised 451 patients after propensity score matching. Complication rates and revision risks were compared between cohorts at 6, 24, and 72 months. Additional analysis stratified patients by interval between bariatric surgery and THA.
RESULTS: At 6-month follow-up, the bariatric cohort had significantly lower risks of surgical site infection, wound dehiscence, and deep vein thrombosis (DVT). At 24 months, the bariatric cohort had a lower risk of DVT. At 72-month follow-up, the bariatric cohort had reduced rates of revision, mortality, cardiac morbidity, and Clavien-Dindo grade IV complications.
CONCLUSIONS: Obese patients who underwent bariatric surgery prior to THA experienced reduced medical complications at all time points and reduced rates of revision at 72 months relative to a matched cohort who did not undergo bariatric surgery.
METHODS: This retrospective cohort analysis utilized multicenter electronic medical record data ranging from 2003 to 2023. Patients who have obesity who underwent THA were stratified based on prior bariatric surgery. The final bariatric cohort comprised 451 patients after propensity score matching. Complication rates and revision risks were compared between cohorts at 6, 24, and 72 months. Additional analysis stratified patients by interval between bariatric surgery and THA.
RESULTS: At 6-month follow-up, the bariatric cohort had significantly lower risks of surgical site infection, wound dehiscence, and deep vein thrombosis (DVT). At 24 months, the bariatric cohort had a lower risk of DVT. At 72-month follow-up, the bariatric cohort had reduced rates of revision, mortality, cardiac morbidity, and Clavien-Dindo grade IV complications.
CONCLUSIONS: Obese patients who underwent bariatric surgery prior to THA experienced reduced medical complications at all time points and reduced rates of revision at 72 months relative to a matched cohort who did not undergo bariatric surgery.
摘要：
背景：肥胖是终末期髋关节骨关节炎（OA）的危险因素。虽然全髋关节置换术（THA）通常用于减轻疼痛和改善与OA相关的功能，肥胖与THA后并发症风险增加相关.虽然减肥手术也可以用来减轻体重，减肥手术对THA结局的影响尚不清楚.
方法：这项回顾性队列分析利用了2003年至2023年的多中心电子病历数据。根据先前的减肥手术对接受THA的肥胖患者进行分层。最终的减肥队列包括451名倾向评分匹配后的患者。在六个队列中比较了并发症发生率和翻修风险，24个月和72个月。其他分析按减重手术和THA之间的间隔对患者进行分层。
结果：在六个月的随访中，减肥队列的手术部位感染（SSI）的风险显着降低，伤口裂开,深静脉血栓形成（DVT）。24个月时,减重队列的DVT风险较低.在72个月的随访中，减肥队列的翻修率降低，死亡率,心脏病发病率,和Clavien-DindoIV级并发症。
结论：与未接受减肥手术的匹配队列相比，在THA之前接受减肥手术的肥胖患者在所有时间点的医疗并发症减少，在72个月时的翻修率降低。
方法：这项回顾性队列分析利用了2003年至2023年的多中心电子病历数据。根据先前的减肥手术对接受THA的肥胖患者进行分层。最终的减肥队列包括451名倾向评分匹配后的患者。在六个队列中比较了并发症发生率和翻修风险，24个月和72个月。其他分析按减重手术和THA之间的间隔对患者进行分层。
结果：在六个月的随访中，减肥队列的手术部位感染（SSI）的风险显着降低，伤口裂开,深静脉血栓形成（DVT）。24个月时,减重队列的DVT风险较低.在72个月的随访中，减肥队列的翻修率降低，死亡率,心脏病发病率,和Clavien-DindoIV级并发症。
结论：与未接受减肥手术的匹配队列相比，在THA之前接受减肥手术的肥胖患者在所有时间点的医疗并发症减少，在72个月时的翻修率降低。
