Severe and morbid obesity (BMI ≥ 35 kg/m2) does not increase surgical time and length of hospital stay in total knee arthroplasty surgery

Abstract

Retrospective comparative study, Level IV.

Tourniquet Use in Total Knee Arthroplasty

“…Unfortunately, data on tourniquet pressure and complication rates for each group were not available in this study. In a similar study, Lozano et al 79 were not able to show a significant difference in tourniquet times across BMI groups. They also found that total operative time and Evaluated the risk of DVT when the tourniquet was released before and after wound closure.…”

Predictive factors for length of hospital stay following primary total knee replacement in a total joint replacement centre in Hong Kong

“…Factors that have been shown in previous studies to have an influence include age, 5 gender, 5 ASA class, 6 type of surgery, 7 requirement for blood transfusion, 8 and in-patient complications. 8,9 Data for the influence of BMI 7,8,10 and preoperative haemoglobin level 3,8,11 are equivocal. We also studied factors not previously examined including the need for drain insertion, postoperative ICU admission, and Foley catheterisation due to urinary retention.…”

Obese patients require higher, but not high pneumatic tourniquet inflation pressures using a novel technique during total knee arthroplasty

“…Previous studies investigated different aspects of obesity in patients who underwent TKA such as operative difficulty, operative time, complications and costs and length of hospital stay. [1][2][3][4][5] Although obese patients often present a problem in tourniquet application due to their excessive subcutaneous tissue, to our knowledge, this is the first study which investigates the relationship between obesity and tourniquet pressures applied in patients undergoing TKA using a novel formula to determine and maintain safer tourniquet pressures. [6] AOP is the lowest pneumatic tourniquet inflation pressure required to stop the arterial blood flow into the limb and its usage has been shown to be useful in optimizing tourniquet cuff pressures.…”

“…[1] Although there are studies which investigated the impact of obesity on operative difficulty, operative time, length of hospital stay, complications and costs, to our knowledge, there is no report studying the optimal pneumatic tourniquet pressures and their effectiveness in obese patients undergoing knee arthroplasty surgery. [2][3][4][5] The use of personalized rather than fixed inflation pressures according to arterial occlusion pressure (AOP) is recommended in tourniquet applications. [6][7][8][9] The most important factors affecting AOP are limb girth and systolic blood pressure, which are known to be higher in obese patients.…”