Alomran AK, Alhaddad S, Alqahtani Y, Bahri Y, Alyami M, Alzawad A, Algurashi W, Khouqeer A, Alhumluji A. Role of obesity in orthopedic surgical outcomes and complications: A retrospective cohort study at King Fahad University Hospital. World J Orthop 2026; 17(7): 121847 [DOI: 10.5312/wjo.121847]
Corresponding Author of This Article
Sarah Alhaddad, College of Medicine, Imam Abdulrahman Bin Faisal University, 95HV + V3M, King Faisal Ibn Abd Al Aziz, Al Safa, Dammam 31441, Saudi Arabia. sarahf.alhaddadn@gmail.com
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Orthopedics
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Alomran AK, Alhaddad S, Alqahtani Y, Bahri Y, Alyami M, Alzawad A, Algurashi W, Khouqeer A, Alhumluji A. Role of obesity in orthopedic surgical outcomes and complications: A retrospective cohort study at King Fahad University Hospital. World J Orthop 2026; 17(7): 121847 [DOI: 10.5312/wjo.121847]
World J Orthop. Jul 18, 2026; 17(7): 121847 Published online Jul 18, 2026. doi: 10.5312/wjo.121847
Role of obesity in orthopedic surgical outcomes and complications: A retrospective cohort study at King Fahad University Hospital
Ammar K Alomran, Sarah Alhaddad, Yazan Alqahtani, Yaser Bahri, Mohammed Alyami, Abdulaziz Alzawad, Wesam Algurashi, Abdullah Khouqeer, Aljaze Alhumluji
Ammar K Alomran, Department of Orthopedic, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
Sarah Alhaddad, Abdulaziz Alzawad, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
Yazan Alqahtani, Yaser Bahri, Mohammed Alyami, Wesam Algurashi, Abdullah Khouqeer, Aljaze Alhumluji, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
Author contributions: Alomran AK was responsible of supervision, project administration, writing review and editing; Alhaddad S, Alqahtani Y, and Bahri Y did the investigation, writing original draft, visualization; Alzawad A and Khouqeer A did the methodology and conceptualization; Alyami M, Algurashi W and Alhumluji A were responsible of investigation, data curation; all of the authors read and approved the final version of the manuscript to be published.
AI contribution statement: AI tools (specifically ChatGPT) were used solely for linguistic refinement and formatting assistance. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board in Imam Abdulrahman Bin Faisal University, No. IRB-2025-01-0285.
Informed consent statement: This study was designed and conducted as a retrospective cohort study using previously collected data. As such, no direct contact or intervention with human participants occurred during the course of the research. In accordance with applicable ethical guidelines and institutional policies, the requirement for informed consent was waived, as the study involved analysis of existing data and posed minimal risk to participants. All data were handled in a manner that ensured confidentiality and anonymity. The study protocol was reviewed and approved by the appropriate Institutional Review Board, which granted the waiver of informed consent.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Data sharing statement: No additional data are available.
Corresponding author: Sarah Alhaddad, College of Medicine, Imam Abdulrahman Bin Faisal University, 95HV + V3M, King Faisal Ibn Abd Al Aziz, Al Safa, Dammam 31441, Saudi Arabia. sarahf.alhaddadn@gmail.com
Received: April 2, 2026 Revised: May 3, 2026 Accepted: June 16, 2026 Published online: July 18, 2026 Processing time: 99 Days and 17.3 Hours
Abstract
BACKGROUND
Obesity is a global health problem, and its prevalence continues to increase significantly each year. It is also associated with many major chronic diseases, such as diabetes and hypertension. Some studies suggest that obesity has a major impact on postoperative complications, but this remains an area of ongoing investigation.
AIM
To evaluate the association between obesity and obesity-associated chronic diseases and the risk of post-orthopedic surgical complications, and to compare the surgical success rate, patient outcomes, and patient satisfaction between obese and non-obese patients.
METHODS
A retrospective cohort study was conducted comparing obese and non-obese patients who underwent elective or emergency orthopedic surgery at King Fahad University Hospital, Al-Khobar, Saudi Arabia, between January 1, 2020, and November 30, 2024. A body mass index cutoff of 30 kg/m2 was used to classify obese patients, and all patients were aged 18 years or older.
RESULTS
After data collection and analysis, obese patients demonstrated a higher incidence of postsurgical complications and a lower success rate than non-obese patients. The complication rate was 26% (n = 48) in obese patients and 7% (n = 12) in non-obese patients. Obese patients had significantly higher complication rates than non-obese patients (odds ratio = 5.0; 95%CI: 2.5-9.8; P < 0.001). The success rate was 74% (n = 136) in obese patients, whereas it was 93% (n = 172) in non-obese patients. The success rate was significantly higher in non-obese patients than in obese patients (odds ratio = 5.0; 95%CI: 2.5-9.8; P < 0.001).
CONCLUSION
Obesity was significantly associated with higher postoperative complication rates and lower success rates. These findings highlight the importance of optimizing preoperative assessment in obese patients by incorporating preoperative weight management and enhanced follow-up care.
Core Tip: Obesity significantly increases the risk of postoperative complications and reduces surgical success rates in orthopedic patients. In this retrospective cohort, obese individuals had markedly higher complication rates and poorer outcomes than non-obese patients. These findings highlight the importance of targeted preoperative optimization, including weight management and careful risk stratification, to improve surgical outcomes in this high-risk population.
