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High Body Mass Index is Related to Increased Perioperative Complications After Periacetabular Osteotomy

August 8, 2018|Surgery
Stephanie W. Mayer, MD;Nicole A. Zelenski, MD;Vasili Karas, MD, MS;Zongping Xie, MD;Steven A. Olson, MD
Author and Disclosure Information

Authors’ Disclosure Statement: The authors report no actual or potential conflict of interest in relation to this article.

Dr. Mayer is an Assistant Professor, Department of Orthopaedic Surgery, University of Colorado, Children’s Hospital Colorado, Aurora, Colorado. Dr. Zelenski is a Resident, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania. Dr. Karas is an Orthopaedic Surgeon, Chicago Orthopaedics and Sports Medicine, Chicago, Illinois. Dr. Xie is an Associate Professor, Department of Orthopaedic Surgery, Hospital #6, Shang Hai, China. Dr. Olson is a Professor, Department of Orthopaedic Surgery, Pelvis and Hip Reconstruction, and Hip Preservation Surgery; and Associate Vice-Chairman, Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.

Address correspondence to: Steven A. Olson, MD, FACS, Department of Orthopaedic Surgery, Pelvis and Hip Reconstruction, Hip Preservation Surgery, Duke University School of Medicine, DUMC 3389, Durham, NC 27710 (tel, 919-668-3000; fax, 919-668-2933; email, Olson016@dm.duke.edu).

Stephanie W. Mayer, MD Nicole A. Zelenski, MD Vasili Karas, MD, MSZongping Xie, MD Steven A. Olson, MD . High Body Mass Index is Related to Increased Perioperative Complications After Periacetabular Osteotomy. Am J Orthop.

August 8, 2018

TAKE-HOME POINTS

  • PAO is an effective procedure to treat symptomatic hip dysplasia in patients without degenerative changes.
  • The postoperative correction of dysplasia as measured by center-edge angles were similar in low and high BMI groups.
  • Patients with obesity (BMI >30) have a higher incidence of postoperative complications following PAO.
  • There were too few patients with diabetes or smoking to determine a significantly increased rate of complications. However, we believe based on the literature these patient populations are at higher risk for complications in the early postoperative period.
  • Patients with BMI >30 can have a successful outcome with a PAO procedure. However, this patient population should have counseling about their increased risk of complications, and be given opportunity to lose weight when possible preoperatively.

ABSTRACT

The purpose of this study is to determine the relationship of body mass index (BMI), age, smoking status, and other comorbid conditions to the rate and type of complications occurring in the perioperative period following periacetabular osteotomy. A retrospective review was performed on 80 hips to determine demographic information as well as pre- and postoperative pain scores, center-edge angle, Tönnis angle, intraoperative blood loss, and perioperative complications within 90 days of surgery. Patients were placed into high- (>30) and low- (<30) BMI groups to determine any correlation between complications and BMI. The high-BMI group had a significantly greater rate of perioperative complications than the low-BMI group (30% vs 8%) and, correspondingly, patients with complications had significantly higher BMI than those without (30.9 ± 9.5, 26.2 ± 5.6) (P = .03). Center-edge angle and Tönnis angle were corrected in both groups. Improvement in postoperative pain scores and radiographically measured acetabular correction can be achieved in high- and low-BMI patients. High-BMI patients have a higher rate of perioperative wound complications.

Continue to: The Bernese periacetabular osteotomy...

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