Higher body mass index is not a risk factor for in-hospital adverse outcomes following total knee arthroplasty

Abstract

Purpose: To investigate the association between body mass index (BMI) and perioperative complications until hospital discharge, following primary total knee arthroplasty (TKA). Methods: 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. Results: 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 ¼ 0.044). Compared to normal weight category, obese class 3 (40 kg/m 2 ) individuals were at 66% (OR: 0.34, 95% CI: 0.21-0.55) lower (unadjusted) odds of developing cardiac complications (overall p < 0.001). With the matched analysis, compared to normal weight category, obese class 3 (40 kg/m 2 ) individuals were at a 60% (OR: 0.40, 95% CI: 0.23-0.68) lower (unadjusted) odds of developing cardiac complications (overall p ¼ 0.004). Obese 3 patients had significantly higher operating time compared with other groups (p < 0.001). Conclusion: This study did not find a significant association between BMI and increased overall in-hospital medical or surgical complications following primary TKA. Obesity significantly increased the length of operating time.

Greater risk of all‐cause revisions and complications for obese patients in 3 106 381 total knee arthroplasties: a meta‐analysis and systematic review

“…One additional article was identified from citation search and 210 full‐text articles were assessed for eligibility. Finally, 91 studies were included, with 22 prospective, 4,7,8,16,22–39 54 retrospective, 6,9–12,14,15,17,40–85 and 15 case‐controlled studies 5,13,18,19,86–96 …”

“…However, literature on TKA complications in the obese population has been inconsistent. Some studies revealed that obese TKA patients had higher peri‐operative complication rates, 4–9 while others reported similar complication and revision rates 10–15 . With the rising severity of obesity globally, the implications of morbid (BMI ≥ 40 kg/m 2 ) and super obesity (BMI ≥ 50 kg/m 2 ) on TKA outcomes is of research interest 16–19 .…”

Early functional results of total knee arthroplasty in patients with alimentary obesity

“…Очевидно, что такие пациенты чаще страдают патологией крупных суставов нижних конечностей, которая прогрессирует уже в молодом возрасте [9,10]. Ожи-рение является условным ограничением для проведения планового эндопротезирования, поскольку в ряде случаев приводит к послеоперационным осложнениям, но специалисты сходятся во мнении, что оно необходимо для повышения качества жизни этой группы пациентов [11][12][13][14].…”

“…Длительность оперативного вмешательства у пациентов с повышенным ИМТ оказалась предсказуемо выше, чем в группе сравнения. Эти данные согласуются с мнением австралийских коллег [14], отметивших значительное увеличение времени вмешательства у пациентов с повышенным ИМТ. Однако работа на коленном суставе у «тучных» пациентов оказалась явно проще, чем в случаях эндопротезирования тазобедренного сустава.…”

“…Период реабилитации не отличался по результатам от такового у пациентов с нормальным ИМТ, что коррелирует с данными других исследователей [13][14][15].…”