Effect of Body Mass Index on the outcomes of primary Total Knee Arthroplasty up to one year-a prospective cohort study (original) (raw)
Related papers
Body mass index and knee arthroplasty
Journal of Clinical Orthopaedics and Trauma, 2020
Objective: this study aims to evaluate the relationship between body mass index (BMI), age at which knee joint arthroplasty is performed and complications. The hypothesis is that the higher the BMI, the greater likelihood that the patient will require surgery at an earlier age. Methods: this is a cohort study with all patients who underwent a primary knee arthroplasty, between August 2013 and February 2019, in a tertiary level university hospital. Association between BMI, age and complications were analyzed. Quality of life of patients was also evaluated with the Oxford Knee Score (OKS). Results: 565 primary total knee replacements (TKR) were performed. A cutoff point was found in BMI of 30; 348 patients had a BMI 30 and 173 patients had a BMI >30. When comparing the two groups, a statistically significant difference (p ¼ 0.0186) was found in the age at which the TKR was performed. There was a significant improvement for both groups in functional score (Oxford knee score). Additionally, intra and post-operative complications showed no statistically significant difference. Conclusion: patients with BMI greater than 30 required primary knee arthroplasty at a younger age (average: 3.5 years), compared to patients with a lower BMI. Obesity does not appear to confer and independent risk for surgery in the short and mid-term. Knee arthroplasty improves significantly quality of life in the short and mid-term, regardless of their BMI, as measured with the OKS.
Journal of orthopaedic surgery (Hong Kong)
To investigate the association between body mass index (BMI) and perioperative complications until hospital discharge, following primary total knee arthroplasty (TKA). This retrospective study reviewed 1665 cases of elective primary unilateral TKA performed between 2006 and 2010, from a prospective secure electronic database. Types of complications, length of operating time, and duration of hospital stay were analyzed in both adjusted (for known confounders) and unadjusted analyses. A further matched analysis was also performed. In terms of overall complications, there was no statistically significant difference between the BMI categories. When individual obesity category was considered, obese 2 had the lowest odds of developing complications, both with unadjusted (odds ratio (OR): 0.61, 95% confidence interval (CI) 0.41-0.91, p < 0.015) and adjusted regression analysis (OR: 0.65, 95% CI: 0.43-0.99, p = 0.044). Compared to normal weight category, obese class 3 (≥40 kg/m) individu...
Background: Obesity is a significant risk factor for developing knee osteoarthritis, and these cases suffer from complications following Total Knee Arthroplasty (TKA). An association between obesity and outcome after TKA is ambiguous. Knowledge is scarce about a definite relation between the two. This study aims to establish a correlation between obesity and early outcomes of TKA. Methods: This prospective cross-sectional study was done in cases undergoing primary knee arthroplasty between September 2019 to August 2020. Obesity was classified in all cases, and multiple variables like pain, functional status, Range of Motion, knee deformity, and Patient Response Outcome Measures were recorded. Statistical analysis was performed using SPSS Statistical Software version 22.0 and R.3.2.0. The level of statistical significance was taken as p < 0.05. Results: We studied 100 knees (37 bilateral and 26 unilateral) in 63 cases. Pain score decreased maximally in the normal and overweight group and minimal in class III obesity (p < 0.001). KSS, FKSS, and PROMs gradually improved in all, except in morbidly obese (p < 0.001). Although the improvement in all variables was minimum in class III obesity compared to other classes of obesity, the margin of difference from the preoperative period was maximum in class III obese participants. Conclusion: All cases, irrespective of class of obesity, experienced a comparable improvement in their knee function and improved quality of life. In addition, the TKA offered substantial benefits in terms of pain relief, knee stability, walking distance, range of movement of the knee, and stair climbing.
Higher Body Mass Index Leads to Longer Operative Time in Total Knee Arthroplasty
The Journal of Arthroplasty, 2013
Obesity has been shown to be a risk factor for degenerative knee arthritis and its incidence is increasing in epidemic proportions. Obesity has also been shown to be a risk factor for surgical complications associated with total knee replacement (TKR) surgery. There have been no prior investigations examining the relationship between body mass index (BMI) and surgical time during TKR. Two hundred and seventy three patients were evaluated and stratified by BMI. There was a direct linear relationship between BMI and operative time. In addition, the higher the BMI group, the younger the age at surgery, and obese class III patients experienced a higher rate of early post-operative complication. Therefore, patients should be counseled that obesity prior to TKR surgery might lead to a longer operative time and any sequelae associated with further exposure of the operative wound, especially with regard to higher rates of prosthetic joint infection (PJI).
The Journal of Arthroplasty, 2011
We assessed whether higher Body Mass Index (BMI) is associated with higher risk of moderatesevere knee pain 2-and 5-years after primary or revision Total Knee Arthroplasty (TKA). We adjusted for gender, age, comorbidity, operative diagnosis and implant fixation in multivariable logistic regression. BMI (reference, <25 kg/m 2) was not associated with moderate-severe knee pain at 2-years post-primary TKA (odds ratio (95% confidence interval): 25-29.9, 1.02 (0.75,1.39), p=0.90; 30-34.9, 0.93 (0.65,1.34), p=0.71; 35-39.9, 1.16 (0.77,1.74), p=0.47; ≥40, 1.09 (0.69,1.73), (all p-values ≥0.47). Similarly, BMI was not associated with moderate-severe pain at 5-year primary TKA and at 2-and 5-yr revision TKA follow-up. Lack of association of higher BMI with poor pain outcomes post-TKA implies that TKA should not be denied to obese patients for fear of suboptimal outcomes.