PMID- 38403079
OWN - NLM
STAT- MEDLINE
DCOM- 20240515
LR  - 20240515
IS  - 1532-8406 (Electronic)
IS  - 0883-5403 (Linking)
VI  - 39
IP  - 6
DP  - 2024 Jun
TI  - Does Your Patient Need to Lose Weight? Weight Change Before and After Total Hip 
      Arthroplasty Does Not Affect Health Care Utilization and Achievement of the 
      Minimal Clinically Important Difference.
PG  - 1404-1411
LID - S0883-5403(24)00170-0 [pii]
LID - 10.1016/j.arth.2024.02.051 [doi]
AB  - BACKGROUND: Despite the potential negative impact of preoperative obesity on 
      total hip arthroplasty (THA) outcomes, the association between preoperative and 
      postoperative weight change and outcomes is much less understood. Therefore, this 
      study aimed to determine the impact of preoperative and postoperative weight 
      change and preoperative body mass index (BMI) on health care utilization, 
      satisfaction, and achievement of minimal clinically important difference (MCID) 
      for Hip Disability and Osteoarthritis Outcome Score Physical Function Short-Form 
      (HOOS PS) and HOOS Pain. METHODS: Patients who underwent primary elective 
      unilateral THA between January 2016 and December 2019 were included (N = 2,868). 
      Multivariable logistic regression assessed the association between BMI and 
      preoperative and postoperative weight change on outcomes while controlling for 
      demographic characteristics. RESULTS: There was no association between 
      preoperative weight change and prolonged length of stay (> 3 days), 90-day 
      readmission, nonhome discharge, patient dissatisfaction at 1 year, or achievement 
      of HOOS Pain or HOOS PS MCID. Postoperative weight loss was an independent risk 
      factor for patient dissatisfaction at 1 year but was not associated with 
      achievement of either HOOS Pain or HOOS PS MCID at 1-year postoperative. 
      Preoperative obesity classes I to III were independent risk factors for nonhome 
      discharge. Nevertheless, preoperative obesity class I and class II were 
      associated with an increased probability of reaching HOOS Pain MCID. Preoperative 
      BMI was not associated with an increased risk of patient dissatisfaction. 
      CONCLUSIONS: Preoperative weight change does not appear to influence health care 
      utilization, satisfaction, or achievement of MCID in pain and function following 
      THA. Postoperative weight loss may play a role as a risk factor for 
      dissatisfaction following THA. Additionally, patients who had a higher baseline 
      BMI may be more likely to see improvement in pain following THA. Therefore, when 
      counseling obese patients for THA, surgeons must balance the risk of 
      perioperative complications with the expectation of greater improvements in pain.
CI  - Copyright (c) 2024 Elsevier Inc. All rights reserved.
FAU - Tidd, Joshua L
AU  - Tidd JL
AD  - Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio; College of 
      Medicine, Northeast Ohio Medical University, Rootstown, Ohio.
FAU - Rullan, Pedro J
AU  - Rullan PJ
AD  - Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
FAU - Oyem, Precious C
AU  - Oyem PC
AD  - Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio; Cleveland 
      Clinic Lerner College of Medicine, Cleveland, Ohio.
FAU - Hadad, Matthew J
AU  - Hadad MJ
AD  - Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
FAU - Pasqualini, Ignacio
AU  - Pasqualini I
AD  - Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
FAU - Huffman, Nickelas
AU  - Huffman N
AD  - Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
FAU - Klika, Alison K
AU  - Klika AK
AD  - Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
FAU - Piuzzi, Nicolas S
AU  - Piuzzi NS
AD  - Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
LA  - eng
PT  - Journal Article
DEP - 20240223
PL  - United States
TA  - J Arthroplasty
JT  - The Journal of arthroplasty
JID - 8703515
SB  - IM
MH  - Humans
MH  - *Arthroplasty, Replacement, Hip
MH  - Female
MH  - Male
MH  - Middle Aged
MH  - Aged
MH  - *Body Mass Index
MH  - *Minimal Clinically Important Difference
MH  - *Weight Loss
MH  - *Patient Satisfaction
MH  - Osteoarthritis, Hip/surgery
MH  - Patient Acceptance of Health Care/statistics & numerical data
MH  - Obesity/complications/surgery
MH  - Postoperative Period
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - length of stay
OT  - minimal clinically important difference
OT  - patient-reported outcome measures
OT  - satisfaction
OT  - total hip arthroplasty
OT  - weight change
EDAT- 2024/02/26 00:42
MHDA- 2024/05/16 00:44
CRDT- 2024/02/25 19:15
PHST- 2023/10/24 00:00 [received]
PHST- 2024/02/15 00:00 [revised]
PHST- 2024/02/19 00:00 [accepted]
PHST- 2024/05/16 00:44 [medline]
PHST- 2024/02/26 00:42 [pubmed]
PHST- 2024/02/25 19:15 [entrez]
AID - S0883-5403(24)00170-0 [pii]
AID - 10.1016/j.arth.2024.02.051 [doi]
PST - ppublish
SO  - J Arthroplasty. 2024 Jun;39(6):1404-1411. doi: 10.1016/j.arth.2024.02.051. Epub 
      2024 Feb 23.