Impact of obesity on functional outcomes and patient satisfaction following total hip arthroplasty in mexican population: a comparative study

José P. Castro-Ruiz, Servicio de Ortopedia y Traumatología, Hospital General Regional No. 220, Instituto Mexicano del Seguro Social (IMSS), Toluca de Lerdo, State of Mexico, México
Víctor M. Cortés-Vital, Servicio de Ortopedia y Traumatología, Hospital General Regional No. 220, Instituto Mexicano del Seguro Social (IMSS), Toluca de Lerdo, State of Mexico, México
Juan Flores-Girón, Servicio de Ortopedia y Traumatología, Hospital General Regional No. 220, Instituto Mexicano del Seguro Social (IMSS), Toluca de Lerdo, State of Mexico, México
Eloy I. Ocaña-Rivera, Servicio de Ortopedia y Traumatología, Hospital General Regional No. 220, Instituto Mexicano del Seguro Social (IMSS), Toluca de Lerdo, State of Mexico, México

Background: Mexico faces a significant obesity epidemic, with over 36% of adults classified as obese. Despite widespread beliefs that obese patients experience inferior outcomes following total hip arthroplasty (THA), limited evidence exists from Mexican populations. This study aimed to compare functional outcomes and patient satisfaction between obese and nonobese patients undergoing THA for coxarthrosis in a Mexican healthcare setting. Material and methods: Cross-sectional, observational analytical study conducted at a second-level hospital between March 2022 and September 2024. Twenty-nine patients who underwent primary THA for coxarthrosis were included, classified into obese (BMI ≥ 30 kg/m2, n = 15) and non-obese (BMI < 30 kg/m2, n = 14) groups. Functional outcomes were assessed using Harris Hip Score (HHS) and satisfaction with a 10-point numerical scale. Mann-Whitney U tests were used for between-group comparisons and Spearman correlation for association analysis. Results: No statistically significant differences were observed in functionality between obese and non-obese groups (HHS: 80.29 ± 17.80 vs 84.62 ± 13.26 points, p = 0.288) or in satisfaction (8.47 ± 2.33 vs 9.07 ± 1.33 points, p = 0.794). A weak negative correlation was found between BMI and functionality (ρ = –0.310) and no correlation with satisfaction (ρ = 0.036). Both groups achieved scores classified as “good” with high satisfaction levels. Conclusions: In this sample obesity did not appear to significantly affect functional outcomes or patient satisfaction following THA for coxarthrosis. These findings challenge common assumptions about inferior outcomes in obese patients and support evidencebased decision-making rather than BMI-based restrictions for THA candidacy in the Mexican population.

Keywords: Obesity. Total hip arthroplasty. Hip osteoarthritis. Patient satisfaction.