The demand for hip arthroplasty is increasing rapidly due to a combination of an aging population as well as an increasing level of obesity in the country. The purpose of this study is to evaluate the risks and benefits of arthroplasty for patients of different obesity classes. The first two parts were to use a systematic review with meta-analysis and retrospective chart review to quantify the risks and benefits in different obesity classes. The third part was to perform a cost-effectiveness analysis to weight the balance between the two. We found that higher obesity classes are at higher risk of complications and comparable improvement after an arthroplasty. Our cost-effectiveness analysis determined that greater obesity levels had a higher incremental cost-effectiveness ratio than lower obesity levels, but was within generally used willingness-to-pay thresholds. In conclusion, patients of all obesity levels have a greater benefit to cost ratio for total hip arthroplasty.
