Impact of Obesity on Postoperative Complications After Total Hip Arthroplasty: A Systematic Review and Meta-Analysis

Background Total hip arthroplasty (THA) is an effective treatment for degenerative hip disease. ‏ ‏However Obesity may increase preoperative risk and postoperative complications this study aimed to evaluate association between preoperative obesity and post operative complication following THA. Questions/Purposes This study aimed to determine whether preoperative obesity is associated with postoperative complication after THA and whether complication rates vary according to BMI category. Methods A systematic review and meta-analysis were conducted according to PRISMA guidelines. PubMed/MEDLINE, the Cochrane Library and Google Scholar were searched for study published between 2015 and 2025 adult patient undergoing primary THA were included. Study quality was assessed using the Newcastle-Ottawa Scale, and pooled odds ratios (OR) were collected using a random-effect model. Thirteen studies with sample size ranging from 39 to 131,576 THA patient were included. Results Obese patient had higher rates of post-operative complication compared with non-obese patient. Meta-analysis showed increased risk of infection (OR 0.39), dislocation (OR 0.63), and revision surgery (OR 0.60). No significant difference was observed in postoperative mortality (OR 0.58) or thromboembolic events (OR 0.69). Conclusion Obesity is associated with increased risk of several postoperative complication following THA, particularly infection, dislocation, and revision surgery. However, mortality and thromboembolic event do not appear to be significantly affected.