Body Mass Index and Revision Total Knee Arthroplasty: Does Cause for Revision Vary by Underweight or Obese Status?

Schmerler, Jessica; Harris, Andrew B.; Srikumaran, Uma; Khanuja, Harpal S.; Oni, Julius K.; Hegde, Vishal

doi:10.1016/j.arth.2023.06.019

Cited by 6 publications

(2 citation statements)

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“…Both low BMI (<18.5 kg/m 2 ) and high BMI (>30 kg/m 2 ) form part of the broad definition of malnutrition and are independent predictors of adverse events in TJA ( 10 , 24 ). Studies have further shown that different BMI classes are associated with different complications ( 44 ).…”

Section: Definitionmentioning

confidence: 99%

“…Underweight patients have increased odds ratios (OR) for aseptic loosening (1.62), periprosthetic fractures (1.5), and dislocation (1.8), with increased 2-year mortality ( 61 , 62 ). Schmerier et al found revisions in underweight patients were more likely to be due to periprosthetic fractures and PJI ( 44 ). Anoushiravani et al compared underweight patients to patients within normal range BMI and found underweight patients were at increased risk for post-operative anaemia and cardiac complications which resulted in higher hospital costs ( 63 ).…”

Section: Definitionmentioning

confidence: 99%

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Malnutrition in total joint arthroplasty: what should the orthopaedic surgeon consider?

Almeida,

Mokete,

Sikhauli

et al. 2024

EFORT Open Reviews

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Total joint arthroplasty (TJA) is rising globally, with an associated increase in associated complications, necessitating increased efforts in prevention of these complications with pre-operative optimisation. Malnutrition has been highlighted as one of the most important pre-operative modifiable risk factors to be addressed in TJA, with the term malnutrition in orthopaedic surgery having a broad definition that encompasses a wide range of nutritional abnormalities from undernutrition to overnutrition contributing to the outcomes of TJA. Complications associated with malnutrition include periprosthetic joint infection (PJI), periprosthetic fracture, dislocations, aseptic loosening, anaemia, prolonged length of stay (LOS), increased mortality, and raised health care costs. Standardised nutritional scoring tools, anthropometric measurements, and serological markers are all options available in pre-operative nutritional assessment in TJA, but there is no consensus yet regarding the standardisation of what parameters to assess and how to assess them. Abnormal parameters identified using any of the assessment methods results in the diagnosis of malnutrition, and correction of these parameters of overnutrition or undernutrition have shown to improve outcomes in TJA. With the multiple nutritional parameters contributing to the success of total joint arthroplasty, it is imperative that orthopaedic surgeon has a thorough knowledge regarding nutritional peri-operative optimisation in TJA.

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Section: Definitionmentioning

confidence: 99%