Obesity Linked to Higher Complications and Longer Recovery in Joint Replacement Surgery: Study Finds

"Patients with a BMI over 30 kg/m² had a higher prevalence of severe osteoarthritis (45% vs. 27%), required longer hospital stays (7.6 vs. 5.4 days), and faced nearly triple the risk of surgical site infections," the researchers reported. The results, published in the journal Cureus, highlight the importance of careful surgical planning and enhanced postoperative care for obese patients to improve recovery and reduce complications.

The researchers note that joint replacement surgery is a common procedure aimed at restoring function and alleviating pain in patients with severe arthritis or joint damage. However, a patient’s weight plays a crucial role in surgical outcomes. Excess body weight adds stress to the joints and affects the healing process after surgery. Obesity further complicates the procedure, leading to increased surgical challenges, delayed recovery, and less favorable outcomes.

Against the above background, Abdul Rahman, Orthopaedic Surgery Unit One, Jinnah Hospital Lahore, Allama Iqbal Medical College, Lahore, PAK, and colleagues seek to evaluate how obesity affects postoperative outcomes in joint replacement surgery by comparing outcomes between obese and non-obese patients.

For this purpose, the researchers conducted a prospective observational study from January 2022 to December 2023, including 186 patients—93 obese (BMI > 30 kg/m²) and 93 non-obese (BMI < 30 kg/m²). They collected data on postoperative complications, mobility, pain scores, comorbidities, and demographics. Statistical analysis was performed using IBM SPSS Statistics Version 25.0, and multivariate logistic regression was applied to identify independent predictors of adverse outcomes.

The study led to the following findings:

• The average BMI was significantly higher in obese patients (34.8 vs. 24.6 kg/m²).
• Severe osteoarthritis was more common in obese patients (45.16% vs. 26.88%).
• Obese patients had longer hospital stays (7.6 vs. 5.4 days).
• Postoperative complications, including surgical site infections, were more frequent in obese patients (11.83% vs. 4.30%).
• Obesity was identified as an independent predictor of poor postoperative outcomes (OR: 2.40).

The findings revealed that obese patients experienced higher rates of postoperative complications, greater pain, reduced mobility, and longer hospital stays, underscoring the significant negative impact of obesity on joint replacement outcomes. Obesity, along with diabetes mellitus and poor preoperative mobility, emerged as an independent predictor of adverse postoperative results, including a higher risk of surgical site infections, delayed wound healing, prosthetic loosening, and revision surgery.

"These findings highlight the need for personalized preoperative assessments, optimized perioperative care, and targeted rehabilitation strategies to improve surgical outcomes and enhance long-term recovery in obese patients." the authors concluded.

Reference:

Rahman A, Abid Hasan H, Ali R, et al. (March 15, 2025) Impact of Obesity on Joint Replacement Surgery Outcomes: A Comparative Study. Cureus 17(3): e80623. doi:10.7759/cureus.80623