Surgeon Experience With Hip Arthroplasty In Severely Obese Patients Reduces The Risk Of Major Complications; Time For a Referral Network to be Considered? 

Description

Alexander Charalambous presented a study on the complications faced by severely obese patients undergoing total hip arthroplasty, highlighting the critical relationship between surgeon experience and surgical outcomes. The study, conducted at Sunnybrook Holland Center in Toronto, leveraged data from various healthcare databases over a decade, involving 4,781 patients and 317 surgeons. Key findings included that severe obesity (defined as a BMI > 40) significantly increased the risk of postoperative complications, particularly infections and revisions. Interestingly, while high surgical volume generally suggests better outcomes, an inverse relationship was seen in this context where specific surgeon experience with severe obesity reduced complication risks, independent of overall surgical volume. Limitations of the study were acknowledged, including a lack of patient-reported outcomes and insufficient data on surgical techniques and implant types. The necessity for improved mentorship and support systems for surgeons dealing with higher BMI patients was emphasized, potentially mirroring successful trauma surgery networks. This discussion raised further questions on managing extreme obesity in surgical candidates, particularly concerning thresholds for surgery based on BMI.

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