Postoperative Complication Rates in the “Super-Obese” Hip and Knee Arthroplasty Population

Bariatric Orthopaedics: Total Knee Arthroplasty in Super-obese Patients (BMI > 50 kg/m2). Survivorship and Complications

“…We identified two previous studies that have included clinical outcomes of TKA in super-obese patients [3,31]. Schwarzkopf et al [31] evaluated outcomes of 137 THAs or TKAs in patients with BMIs of 45 to 70 kg/m 2 compared with 63 patients who had BMIs less than 25 kg/m 2 .…”

“…Schwarzkopf et al [31] evaluated outcomes of 137 THAs or TKAs in patients with BMIs of 45 to 70 kg/m 2 compared with 63 patients who had BMIs less than 25 kg/m 2 . Although they did not specify how many patients who had TKAs were super obese (BMI [ 50 kg/m 2 ), they reported an 8.44 higher odds of postoperative complications while the patients were hospitalized (p = 0.05) and a 1.61 increase in odds of having postoperative complications within the first year when their morbidly obese and superobese patients were compared with the matching group.…”

“…However, only a couple recent reports evaluated TKA outcomes in superobese patients (BMI C 50 kg/m 2 , or those exceeding estimated ideal body weight by approximately 225%, such as a 6-feet tall individual who is approximately 200 pounds overweight) [3,31]. Those studies reported a higher rate of medical and surgical complications.…”

Percent Body Fat More Associated with Perioperative Risks After Total Joint Arthroplasty Than Body Mass Index

“…One notable exception was the dramatically higher rate of increased LOS N3 days for the obese by PBF (66.9%) compared to obese by BMI (32.2%). Several recent studies have also demonstrated the importance of obesity BMI thresholds associated with increased complications and increased LOS [12,14]. Although PBF does not further sub-classify obese from morbidly obese patients by definition, the results appear to show higher postoperative complication rates in the obese group as defined by the current PBF classification system.…”

“…The majority of the current literature would indicate higher perioperative complication rates following TJA in the obese population including longer operative times, increased wound complications/infections, and increased hospital length of stay (LOS) and cost [11][12][13][14]. However, obesity risk assessment is a complicated condition that is compounded by other associated major comorbidities (diabetes mellitus, hypertension, coronary artery disease) that independently increase surgical risk [15].…”