Evaluation of Fat Distribution as a Potential Risk Factor for Infection and Wound Healing Complications in Total Hip Arthroplasty

Purpose: Surgical site infection (SSI) following joint replacement is a feared complication, as it is associated with worsened outcomes for both the patient and the healthcare system. There is conflicting evidence regarding BMI as a risk, as it does not consider body composition or the distribution of fat relative to the surgical site. This study evaluated the relationship between site-specific fat distribution and SSI following total hip arthroplasty (THA). Methods: Prospective data collection of surgical-site fat depth measured intraoperatively from the skin surface to the center of the greater trochanter. The ratio between fat depth and the size of the lateral trochanter was determined. Chart review of surgeries (n=98) to collect information on patient history, demographics, and various risk factors. Conclusion: Data collected in this study illustrates a statistically significant risk of THA SSI and wound healing complications with higher BMI and a statistical trend with increased localized fat distribution; however, evaluation of a larger patient population will be important to fully characterize the risk factors of THA postoperative complications and the impact of localized fat distribution.