24 Dec 2025 • Total hip arthroplasty (THA) resulted in substantial functional improvement even in patients with extreme obesity, despite a markedly higher risk of early revision.

In a new study of 7,458 patients undergoing primary THA, those with a body mass index (BMI) ≥50 had nearly a 12-fold higher risk of revision within the first postoperative year compared with overweight patients (aHR 11.8). Patients with a BMI of 40–50 also faced elevated early revision risk (HR 3.8). Excess revision risk was largely confined to the first year; revision rates beyond that period were comparable across weight categories. While baseline hip function was poorer in patients with extreme obesity, postoperative gains were substantial, and by five years, functional outcomes were similar across all BMI groups.

The study highlights a surgical trade-off, with extreme obesity driving early revision risk but not diminishing long-term outcomes or satisfaction.

Source: Science Direct | Read full story