Proportion of Obese Patients Presenting to Orthopedic Total Joint Arthroplasty Clinics

Abstract

The purpose of this study is to demonstrate that the percentage of obese individuals initially presenting to total joint arthroplasty clinics in a public, tertiary hospital is greater than the proportion of obese individuals in the general population. In a retrospective, comparative study of patients seen in total joint replacement clinics at a public, tertiary hospital with an ICD-9 diagnosis of hip or knee osteoarthritis and documented body mass index, the proportion of obese individuals was compared with recent obesity data for the general population from the Centers for Disease Control and Prevention. Patients who had previously undergone hip or knee replacement surgery were excluded. Comorbid conditions, functional comorbidity index (FCI) scores, and Charlson comorbidity index scores were compared between obese and nonobese cohorts. The study included 499 patients aged 20 to 92 years (mean, 64.3 years), 58.9% of whom were female. Fifty-five percent of patients were obese, a significantly greater percentage than in the national (34.9%; P<.0005; odds ratio [OR]=2.23), regional (29.5%; P<.0005; OR=2.85), and state (31.1%; P<.0005; OR=2.64) populations. Obese patients had significantly more comorbid conditions (P<.002) and higher functional comorbidity index scores (P<.0009). The number of comorbidities and having Medicare/Medicaid insurance were predictive of obesity. This study highlights that the majority of patients presenting to orthopedic total joint arthroplasty clinics are obese and that they come with significantly more comorbidities. The total joint surgeon has a unique opportunity to facilitate weight loss in the obese osteoarthritic patient prior to joint replacement.

Study of early warning for desaturation provided by Oxygen Reserve Index in obese patients

“…The prevalence of obese (body mass index (BMI) > 30 kg m −2 ) patients presenting for elective surgery is increasing [19]. It is predicted that by 2030 nearly 50% of the US adult population will be obese [20], while in some surgical populations obesity prevalence may reach 55% [21]. Obese patients have increased incidences of perioperative complications including atelectasis, difficult mask ventilation, difficult intubation and hypoxia [22][23][24].…”

Association of tourniquet utilization with blood loss, rehabilitation, and complications in Chinese obese patients undergoing total knee arthroplasty

“…TKA is the recommended therapy for end-stage knee disease, and there are more and more obese patients undergoing TKA. [ 5 – 7 ] Obesity changes the length and depth of operative incision, disturbs the anatomical position, increases the operative difficulty, and prolongs the operation time, leading to bleeding increase. [ 8 – 10 ] Prior studies have reminded us that obese patients have more blood loss volume.…”

“…Obese populations account for 44% to 55% of patients undergoing TKA, and this proportion is increasing year after year. [ 5 , 6 ] It is not clear at present whether tourniquet utilization is associated with blood loss, rehabilitation, and complications, and it is imperative to ascertain the tactics of utilizing tourniquet in obese patients undergoing TKA. The present study was designed to explore the association of tourniquet utilization with blood loss, rehabilitation, and complications, and ascertain the tactics of utilizing tourniquet in obese patients undergoing TKA.…”

Obesity as a Risk Factor in Primary Total Hip Arthroplasty

“…The increased BMI leads to endoprosthetic treatment at earlier age and with poorer preoperative function (Guenther et al, 2015). Welton et al (2016) determined a significantly higher percentage of obese people from initial candidates for total hip arthroplasty in comparison to the percentage of obese people in general population. The ratio was 55%:35%.…”