OBJECTIVE:To determine whether 12-month hip and knee outcomes of a regional arthroplasty clinic were comparable to results from metropolitan-based clinics, and to explore a possible relationship between body mass index and depression to identify groups at risk of not achieving optimal outcomes. DESIGN:A prospective observational study. SETTING:A regional physiotherapy-led post-arthroplasty review clinic. PARTICIPANTS:Patients after hip or knee replacement. INTERVENTIONS:Patients underwent either total hip or total knee joint arthroplasty. MAIN OUTCOME MEASURES:SF-12 Health Survey, Oxford Hip/Knee Scale, 10-minute walk test, knee range of motion, body mass index and the Hospital Anxiety and Depression Scale. RESULTS:Physical outcomes were comparable to those reported by metropolitan-based clinics. People with a high body mass index showed most improvement in the severity of depression compared to those with a lower body mass index. CONCLUSION:It is important to consider the long-term effects of obesity on arthroplasty outcomes.