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J Arthroplasty. 2013 Sep;28(8 Suppl):41-4. doi: 10.1016/j.arth.2013.05.035. Epub 2013 Jul 30.

Are morbidly obese patients undergoing total hip arthroplasty at an increased risk for component malpositioning?

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1
Department of Orthopaedic Surgery, Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts.

Abstract

Acetabular cup positioning is a critical factor in determining adverse clinical outcomes in THA. This evaluation was performed to determine if morbid obesity (BMI ≥35kg/m(2)) is a contributing risk factor to cup malpositioning. Two groups of patients were obtained from a local arthroplasty registry and match-controlled for gender, age, and diagnosis (n=211 morbidly obese; n=211 normal). Intraoperative data and postoperative AP pelvis and cross-table lateral radiographs were obtained for each patient. The Martell Hip Analysis Suite was used to calculate cup positioning (successful positioning defined as 30°-45° of abduction, and 5°-25° of anteversion), as well as varus-valgus alignment of the femoral stem. There was a significant correlation between morbid obesity with respect to underanteversion; using multivariate analysis, there was a trend toward a combined underanteversion/overabduction of the acetabular cup. Of all variables considered, high BMI was the most significant risk factor leading to malpositioning.

KEYWORDS:

component malpositioning; obesity; total hip arthroplasty

PMID:
23910510
DOI:
10.1016/j.arth.2013.05.035
[Indexed for MEDLINE]
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