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Costs of Hip Replacements in Obesity

sharma-obesity-pelvisOsteoarthritis is a common complication of obesity.

Although surgical outcomes of hip-replacement surgery are no worse than in non-obese patients, a paper by Hilal Maradit Kremers and colleagues, published in Clinical Orthopaedics and Related Research, suggests that the in-patient and post surgical costs of this procedure in obese patients may be higher.

The study included 8973 patients who had undergone 6410 primary and 2563 revision hip replacements at a large US medical center between January 1, 2000, and September 31, 2008.

Mean length of stay and the direct medical costs were lowest for patients with a BMI of 25 to 35 kg/m2 with increasing levels of BMI associated with with both longer hospital stays and costs.

For every 5 units increase in BMI beyond 30 hospital costs increased by about USD 500 with about USD 900 higher costs in the first 90 days post surgery.

In obese patients undergoing revision surgery, the costs were even higher with USD 800 and USD 1500 additional costs per 5 units increase in BMI for hospital stay and 90 day costs, respectively.

These higher costs of hip-replacement surgery in obese patients may well be offset by the substantial improvements in pain, mobility and quality or life that these patients experience.

Whether or not all or some of these costs could be saved by pre-surgical weight loss remains to be seen.

Edmonton, AB


  1. I wonder, if the “lowest for patients with a BMI of 25 to 35 kg/m2 with increasing levels of BMI associated with with both longer hospital stays and costs.” What about the cost of those with a BMI under 25?

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    • @Vic: good point – the cost for many procedures due to complications also goes up in people considered underweight – this is often ignored or discussed less in the media.

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  2. I am 62 yrs old, morbidly obese (360 lbs at 5’5″) and have arthritis in my right hip. It is painful and as a result I can barely walk down the hall to the elevator using a walker so don’t go outside and spend my time sitting. I have wondered whether (1) a surgeon would even consider me for hip replacement, (2) if I got it, how long would it take to recover, (3) would I really be better off after it and (4) would it have to be redone again in several years. The waiting time here in BC is up to a year.

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  3. Dr Sharma, thank-you for your answer.

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