Abstract
Objective.
Obese patients have a higher prevalence of total hip arthroplasty (THA) and they are likely to experience a higher rate of pre-operative and post-operative complications. Pre-operative templating is a standard method of THA planning aiming to minimize the risk of complications. The accuracy of pre-operative templating depends on the knowledge of radiographic magnification factor. Whether and to what extent obesity affects radiographic magnification is not well described in literature. The purpose of this study was to determine whether obesity type affects hip radiographic magnification and quantify the relationship between the obesity measured and change in radiographic magnification.
Materials and Methods.
Digital radiographs of 303 patients who underwent THA were taken from clinical archives. The size of implanted femoral head was taken as an internal calibration marker to estimate hip radiographic magnification. Patients were stratified into obesity categories by body mass index (BMI). Patients’ mass, BMI, and body surface area (BSA) were studied as predictors of hip magnification.
Results.
There is a significant effect of obesity type on hip radiographic magnification (one-way ANOVA, p<0.001). The radiographic magnification correlates with patients’ mass (r=0.443, p<0.001), BMI (r=0.450, p<0.001) and BSA (r=0.443, p<0.001). For every 17 kg increase in patients’ mass, 5 kg/m2 increase in the BMI and for every 0.27 m2 in the BSA there is a 1 percent increase in the hip radiographic magnification. The increase in hip radiographic magnification with mass, BMI, and BSA is higher in females than in males.
Conclusion.
BMI could be used to estimate the increase in hip radiographic magnification due to obesity by adding 1% of magnification on average for each subsequent BMI category.