Trends of obesity rates between primary total hip arthroplasty patients and the general population from 2013 to 2020

Abstract

Background: The prevalence of obesity in total hip arthroplasty (THA) patients has been studied in the past. However, there has not been direct comparison against obesity in the general population. This study compared yearly trends in BMI and obesity rates between patients who had undergone primary THA and those from the general patient population. Methods: We retrospectively reviewed all patients over the age of 18 who underwent primary, elective THA and those who had an annual routine physical exam between January 2013 and December 2020 at our academic tertiary medical center. Baseline demographics were controlled in our statistical models. Significance of yearly trends was determined through a linear regression analysis. Independent samples t-test and Chi-square test were used to compare means and proportions between the two groups, respectively. Results: A total of 11,250 primary THA patients and 1,039,918 annual physical exam patients were included. Average BMI for the THA group was significantly higher (P < 0.001) each year compared to the annual physicals group (APG). Higher obesity rates were observed in all obesity subgroups (all classes, and class I–III individually) for THA patients each year compared to the APG. Interestingly, while we found a significantly increasing trend in obesity for the general population (P < 0.001), BMI and obesity rates remained stable in the THA population. Conclusion: While our general patient population showed significant increase in BMI and obesity over time, THA patients had higher, yet stable, BMI. Further investigation is required to determine the role of risk optimization in these findings. Level III Evidence: Retrospective Cohort Study.