Is obesity A contra-indication for a successful total knee arthroplasty?

Abstract

Background: Total Knee Arthroplasty (TKA) is one of the most effective treatment modalities for chronic knee pain and disability. A strong association exists between obesity and early knee osteoarthritis. Various studies on outcomes of TKA in obese patients have been inconclusive. The purpose of this retrospective evaluation is to assess the influence of obesity on outcomes of TKA in Indian patients. Methods: This retrospective study conducted from 2010 to 2016 included 402 knees in 213 patients with Body Mass Index (BMI) between 30 and 39.99 kg/m 2 followed up for a minimum of 12 months. All cases of revision TKAs and those with follow up less than a year were excluded from the study. Patients were followed up regularly for examining their wound healing, post operative complications if any and knee range of motion. Regular radiographs were taken to observe any evidence of loosening. Post-operative knee society scores(KSS) were recorded at each follow up. Improvement in the scores and activity level was noted. Results: The objective KSS improved from 55.88 to 93.01 at the last follow up while the functional scores improved from 52.91 to 80.63. Post surgery improvement in activity level was seen in 71.83% patients. Complications seen in the study included patello-femoral pain, superficial wound infections, deep vein thrombosis and delayed wound healing. No cases of deep infection or revision surgeries were seen in our series. Conclusions: The outcome of TKA in non-morbidly obese patients is comparable to non-obese patients with excellent post-operative objective and functional scores. The benefits are sustainable over a long duration of time. The complication rates in obese patients is no different than non-obese patients.

Is obesity a contraindication for simultaneous bilateral total knee arthroplasty? A prospective case–control study

“…Similar results have been reported by Amin et al [14], patients where obese patients undergoing TKA had similar outcomes compared to non-obese patients. In our retrospective series of 402 TKA in 213 patients, we have observed that functional scores and complication rates in obese patients are comparable to the historical control of non-obese patients [21].…”

Machine learning approach to predicting persistent opioid use following lower extremity joint arthroplasty

“…Similarly, we found that increased body mass index was an important feature predictive of persistent opioid use after lower extremity arthroplasty. This can be secondary to limitation to the progression of inpatient rehabilitation postoperatively36 or pharmacokinetics, however, outcomes and complications in obese patients are comparable to non-obese patients 37–39…”

“…This can be secondary to limitation to the progression of inpatient rehabilitation postoperatively 36 or pharmacokinetics, however, outcomes and complications in obese patients are comparable to non-obese patients. 37–39 …”

CORR Insights®: Is Operative Time Associated With Obesity-related Outcomes in TKA?

“…Another study found no difference in outcomes for patients who have Class 1 or Class 2 obesity compared with patients who are not obese [3], so should we concentrate on exploring these relationships just in patients with BMIs over 40 kg/m 2 , over 45 kg/m 2 , or over 50 kg/m 2 [21]?…”

“…There are many avenues to explore: Some studies have shown that more experience with doing TKA in patients with morbid obesity leads to shorter operative times and fewer adverse postoperative outcomes [14, 23]. Another study found no difference in outcomes for patients who have Class 1 or Class 2 obesity compared with patients who are not obese [3], so should we concentrate on exploring these relationships just in patients with BMIs over 40 kg/m 2 , over 45 kg/m 2 , or over 50 kg/m 2 [21]?…”