A study presented at the American Association of Hip and Knee Surgeons annual meeting in Dallas, Texas in November 2015 looked at a group of 257 revision total hip replacement surgeries performed at Stanford Hospital in Palo Alto, California. The researchers looked at the impact of body mass index (BMI) on implant survivorship. They found that an increased BMI was linked to earlier revision for hip replacement surgery. The most common cause of revision was loosening/osteolysis. Loosening was the primary mode of failure in approximately half of the 92 revision surgeries performed in obese individuals.
While it has been clearly documented that a BMI greater than 30 is associated with a higher rate of postoperative complications in total hip replacement, this study showed that obesity is linked to a higher risk of early failure and need for revision due to loosening of the implants. This study highlights the importance of optimizing patients prior to elective joint replacement surgery so that risks of early failure, such as loosening, can be diminished.