Obesity Increases Risk for Infection After Hip Replacement Surgery
Obesity is associated with a higher risk for prosthetic joint infection (PJI) following total hip arthroplasty (THA) among elderly individuals, according to a recent study.
PJI is more common following arthroplasty in the elderly and is associated with a significantly increased 5-year risk for mortality. It is not yet known whether PJI correlates with higher body mass index (BMI).
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For their study, the researchers evaluated a retrospective cohort of 13,755 geriatric arthroplasty patients older than 75 years, of whom 6408 underwent THA and 7347 underwent total knee arthroplasty (TKA). Mean patient age was 82 years, and mean BMI was 28.1 kg/m2. Administrative hospital data and ICD-9 codes were used to identify cases. Patients with a BMI below 14 kg/m2 or above 60 kg/m2, a height below 142 cm or above 200 cm, and/or a weight below 36 kg or above 226 kg were excluded from the study.
Chart review confirmed the presence of infection. All PJIs included in the present analysis had met Musculoskeletal Infection Society (MSIS) criteria. The researchers defined obesity as a BMI above 30 kg/m2. χ 2 tests were used to perform univariate analyses, and logistic regression was used to examine adjusted models.
Prior to adjustment, results indicated that obesity was associated with higher rates of infection in THA, but not in TKA. This association remained significant following adjustment for age, sex, and diabetes status.
“Obesity increases [THA] PJI risk in the elderly,” the researchers concluded. “However, no such association was found for TKA. Future studies are needed to quantify the compounded risk of obesity in the geriatric arthroplasty patient.”
—Christina Vogt
Reference:
Nocon A, Henry M, Russell C, Westrich G, Brause B, Miller A. The influence of obesity on the infection risk of prosthetic joint infection in the geriatric orthopedic population. 2017;4(Suppl 1):S98. Open Forum Infect Dis. https://doi.org/10.1093/ofid/ofx163.076.