Obesity is associated with an increased risk of undergoing shoulder arthroplasty in Australia

Background: The aim of this study was to examine the incidence of overweight and obesity in patients undergoing primary total shoul-der arthroplasty (TSA) for osteoarthritis (OA) in Australia compared to the incidence of obesity in the general population. Materials and Methods: A 2017/18 cohort consisting of 2997 patients from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) who underwent TSA were compared with matched controls from the Australian Bureau of Statistics (ABS) National Health Survey from the same time period. The 2 groups were analyzed according to body mass index (BMI) category, sex, and age. Results: According to the 2017/18 National Health Survey, 35.6% of Australian adults were overweight and 31.3% were obese. Of the primary TSA cases performed, 34.9% were overweight and 50.1% were obese. The relative risk of requiring TSA for OA increased with increasing BMI category. Class III obese females, aged 55-64, were 8.6 times more likely to receive a TSA compared to their normal weight counterparts. Males in the same age and BMI category were 2.5 times more likely. Class III obese patients underwent TSA 4 years (female) and 6 years (male) younger than their normal weight counterparts. Conclusion: Obesity significantly increases the risk of requiring TSA. The association appears to be particularly strong for younger females. Level of evidence: Level III; Cross-Sectional Design; Epidemiology Study & COPY; 2023 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.