{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:42:56Z","timestamp":1760150576844,"version":"build-2065373602"},"reference-count":24,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T00:00:00Z","timestamp":1700784000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Overweight patients have higher complication rates during and after surgical procedures. In total hip arthroplasty (THA), postoperative infection is a major complication. In this study, we show that the patient\u2019s body mass index (BMI) can be approximated by a newly developed grading system using preoperative X-rays. Furthermore, we show that a higher score and BMI result in a higher risk of infection. For this retrospective study, 635 patients undergoing THA or revision surgeries in 2018 and 2019 were included. The preoperatively acquired X-rays of the pelvis were analyzed using a four-stage grading system. The infection rate was compared to our score and the patients\u2019 BMI. The mean BMI (95% confidence) of all patients graded as grade 0 was 25.16 (24.83; 25.50) kg\/m2, for grade 1, it was 30.31 (29.52; 31.09) kg\/m2, for grade 2, it was 35.06 (33.59; 36.54) kg\/m2, and it was 45.03 (39.65; 50.41) kg\/m2 for grade 3. The risk of infection was 4% in patients with normal radiographs, rising from 7% in patients graded as 1 up to 18% in each of the highest categories. This study shows that we were able to create a semi-quantitative grading tool for the abdominal contour displayed on X-rays of the pelvis in order to estimate the patients\u2019 BMI and therefore the infection rate. A higher abdominal contour grade showed higher infection rates at follow-up.<\/jats:p>","DOI":"10.3390\/jcm12237277","type":"journal-article","created":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T03:54:35Z","timestamp":1700798075000},"page":"7277","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A New Method for Assessing Patients\u2019 Obesity-Associated Infection Risk Using X-rays in Hip Arthroplasties"],"prefix":"10.3390","volume":"12","author":[{"given":"Sebastian","family":"Breden","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Sports Orthopedics, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0273-0643","authenticated-orcid":false,"given":"Florian","family":"Hinterwimmer","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Sports Orthopedics, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany"},{"name":"Institute for AI and Informatics in Medicine, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Beischl","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Sports Orthopedics, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7518-2177","authenticated-orcid":false,"given":"Sarah","family":"Consalvo","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Sports Orthopedics, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra S.","family":"Gersing","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, University Hospital Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich","family":"Lenze","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Sports Orthopedics, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R\u00fcdiger","family":"von Eisenhart-Rothe","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Sports Orthopedics, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2594-2419","authenticated-orcid":false,"given":"Carolin","family":"Knebel","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Sports Orthopedics, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1016\/S0140-6736(14)60460-8","article-title":"Global, regional, and national prevalence of overweight and obesity in children and adults during 1980\u20132013: A systematic analysis for the Global Burden of Disease Study 2013","volume":"384","author":"Ng","year":"2014","journal-title":"Lancet"},{"key":"ref_2","first-page":"21","article-title":"Overweight and obesity among adults in Germany\u2014Results from GEDA 2019\/2020-EHIS","volume":"7","author":"Schienkiewitz","year":"2022","journal-title":"J. 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