Influence of body mass index in revision total knee arthroplasty

Carvalho, Rogério Teixeira de; Neto, Diego Benone Santos; Chammas, Victor; Arrebola, Lucas Simões; Colombo, Mauricio Lebre; Scalizi, Caetano

doi:10.1590/1413-785220152306140199

Cited by 5 publications

(5 citation statements)

References 18 publications

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“…Our results suggest that functional outcome is an important predictor of patient satisfaction following RTKA. Other authors have reported that increased BMI in RTKA is associated with poorer functional outcomes, increased early readmission and complication rates post‐operatively 25,26 . The reason for improved satisfaction in the higher BMI patients within our cohort is not clear, however further investigation into the high BMI cohort of RTKA patients is of increasing importance due to the trends of BMI increase in the RTKA patient population 27 .…”

Section: Discussionmentioning

confidence: 73%

“…Other authors have reported that increased BMI in RTKA is associated with poorer functional outcomes, increased early readmission and complication rates post-operatively. 25,26 The reason for improved satisfaction in the higher BMI patients within our cohort is not clear, however further investigation into the high BMI cohort of RTKA patients is of increasing importance due to the trends of BMI increase in the RTKA patient population. 27 Shorter operative times typically occur with less complex surgical cases and higher volume surgeons, which is further associated with lower complication rate and fewer re-revisions.…”

Section: Discussionmentioning

confidence: 94%

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Assessment of patient satisfaction following revision total knee arthroplasty

Quinn

Jones

Randle

2023

ANZ Journal of Surgery

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Background Patient satisfaction is becoming an increasingly important measure of healthcare quality. Satisfaction following RTKA is poorly described within the literature, resulting in difficulty for clinicians to manage patient expectations and obtain informed consent. Methods We investigated postoperative satisfaction of RTKA patients by a single surgeon, using a single prosthesis, at a single institution. Patient satisfaction was assessed using structured telephone assessment questionnaires and review of orthopaedic/hospital records. The effect of patient and surgical characteristics on satisfaction was assessed using correlation coefficients and binary logistic regression in SPSS. Results Two hundred and two RTKAs were performed in 178 patients between 2004 and 2015 inclusive. One hundred and twenty‐four patients (143 RTKAs) were contactable to complete satisfaction assessment. Eighty‐five percent of patients were satisfied and would have the RTKA again, 8% were unsure, 7% would not. Mean reported satisfaction on a numerical scale (1–10) was 8.17 (range 1–10), with 74% of patients scoring 8 or above, and 35% of patients scoring 10. The Mahomed Satisfaction Scale outcomes demonstrated a mean score of 87.7. High positive correlation was found between assessment tools. Logistic regression analysis identified factors contributing to satisfaction included ROM, OKS, BMI, and surgical time. Conclusion This cohort demonstrated high patient satisfaction rate following RTKA, utilizing simple and reliable outcome measurement tools. We found a high positive correlation between methods of assessment, and moderate positive correlation between satisfaction and functional outcomes. These results contribute to the understanding of satisfaction in RTKA patients, which may assist in informing patients of expected post‐operative outcomes.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 94%

Assessment of patient satisfaction following revision total knee arthroplasty

Quinn

Jones

Randle

2023

ANZ Journal of Surgery

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“…Aus Initial n = 118 Suchergebnissen unter den o. g. Suchtermini erfüllten trotz der weit gefassten Parameter nur 5 Studien alle Einschusskriterien (s. ▶ Tab. 1) [18][19][20][21][22]. Der Publikationszeitraum der Studien lag zwischen 2011 und 2017.…”

Section: Ergebnisseunclassified

“…aseptischer und septischer Patienten gemacht. In der Studie von Bieger et al wurden nur aseptische Patienten nachuntersucht, de Carvalho et al hingegen untersuchten septische und aseptische Patientengruppen [20,21]. Die Studien zeigten jedoch, dass Patienten mit einem septischen revisionsendoprothetischen Eingriff generell eine schlechtere postoperative Funktion und erhöhte Schmerzscores haben.…”

Section: Diskussionunclassified

Adipositas in der Revisionsendoprothetik des Kniegelenks – eine systematische Literaturübersicht und rechtliche Bewertung

Plöeger¹,

Müller²,

Wirtz³

et al. 2018

Z Orthop Unfall

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Five studies met the inclusion criteria and were included in the systematic review. The average Jadad score was 1, the average level of evidence 3. In two studies, infection and revision occured more often in obese patients. Patients with morbid obesity had a higher risk of wound revision and periprosthetic joint infections. Three studies showed that obese patients had significantly lower scores for clinical outcome measures in function and pain. The legal aspect was not discussed in any of the five studies. Overall, published data are sparse and very heterogeneous. Therefore comparing these five studies is difficult. However, the results of our review suggest that obesity in revision total knee arthroplasty may have a negative influence on reoperation rate, infection rate and postoperative functional outcome. From a legal point of view, potential weight limitations of the implants intented for use have to be part of the oral preoperative discussion. The patient's informed consent has to be received and documented prior to revision total joint arthroplasty.

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“…An early study by Bieger et al reported that body mass index (BMI) had no effect on complications after rTKA, whereas other studies noted a correlation between obesity and complications, readmissions, and worse functional outcomes after rTKA. [14][15][16][17] In addition, the potentially different influence of morbid obesity when compared with obesity on postoperative outcomes is little understood. Overall, a better understanding of this patient population characteristics and the effect of obesity and morbid obesity on postoperative complications and economic outcomes after rTKA is important for perioperative optimization and patient counseling and education, especially given the growing subset of obese patients among rTKA recipients.…”

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confidence: 99%

Epidemiology of Obese Patients Undergoing Revision Total Knee Arthroplasty: Understanding Demographics, Comorbidities, and Propensity Weighted Analysis of Inpatient Outcomes

et al. 2022

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Introduction:Obesity is a public health epidemic that is projected to grow in coming years. Observational data on the epidemiologic profile and immediate postoperative outcomes of obesity and morbid obesity after revision total knee arthroplasty (rTKA) are limited.Methods:Discharge data from the National Inpatient Sample was used to identify patients who underwent rTKA from 2006 to 2015. Patients were stratified into morbidly obese, obese, and not obese control cohorts. An analysis was performed to compare etiology of revision, demographic and medical comorbidity profiles, and immediate in-hospital economic and complication outcomes after rTKA.Results:An estimated 605,603 rTKAs were included in this analysis. Morbidly obese and obese patients were at significantly higher risk for any complication than not obese patients. Patients with obesity were associated with an increased risk of postoperative anemia but a lower risk of peripheral vascular disease and gastrointestinal, and hematoma/seroma complications compared with not obese patients. Patients with morbid obesity were associated with an increased risk of any, hematoma/seroma, wound dehiscence, postoperative infection, pulmonary embolism, and postoperative anemia complications and a lower risk of gastrointestinal complications when compared with not obese patients. Morbidly obese patients had a significantly longer length of stay than both obese and not obese patients, while no significant difference in length of stay was observed between obese and not obese patients.Discussion:Morbidly obese patients are at higher odds for worse postoperative medical and economic outcomes compared with those with obesity after rTKA. As the number of patients with obesity and morbid obesity continues to rise, these risk factors should be considered in preoperative discussions and perioperative protocol optimization.

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Influence of body mass index in revision total knee arthroplasty

Cited by 5 publications

References 18 publications

Assessment of patient satisfaction following revision total knee arthroplasty

Assessment of patient satisfaction following revision total knee arthroplasty

Adipositas in der Revisionsendoprothetik des Kniegelenks – eine systematische Literaturübersicht und rechtliche Bewertung

Epidemiology of Obese Patients Undergoing Revision Total Knee Arthroplasty: Understanding Demographics, Comorbidities, and Propensity Weighted Analysis of Inpatient Outcomes

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