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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/m² 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.

SUBMITTER: Agarwala S

PROVIDER: S-EPMC6985028 | biostudies-literature | 2020 Jan-Feb

REPOSITORIES: biostudies-literature

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Publications

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

Agarwala Sanjay S Jadia Chintan C Vijayvargiya Mayank M

Journal of clinical orthopaedics and trauma 20181130 1

<h4>Background</h4>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.<h4>Methods</h4>This retrospective study conducted from 2010 to 2016 included 402 knees in ...[more]

PMID: 32002002

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Project description:BackgroundThere is an existing perception that obesity has a negative impact on complications following total knee arthroplasty (TKA). However, data on the impact of obesity levels on patient-reported outcomes (PROMs) is sparse. We investigated the association between different obesity classes with PROMs among patients who underwent TKA.MethodsWe performed retrospective secondary analyses on data extracted from the total joint replacement data repository (Alberta, Canada) managed by the Alberta Bone and Joint Health Institute (ABJHI). Patients had WOMAC and EQ5D scores measured at baseline in addition to 3 and/or 12 months following TKA. Patients were stratified according to the World Health Organization (WHO) classification, into five body mass index (BMI) groups of normal, overweight, BMI class I, BMI class II, and BMI class III. The association between BMI and mean changes in WOMAC subscales (pain, function, and stiffness) and EQ-5D-5L index over the time intervals of baseline to 3 months and 3 to 12 months following TKA was assessed. Linear mixed-effects models were used, and the models were adjusted for age, sex, length of surgery, comorbidities, year of surgery, and geographical zone where the surgery was performed.ResultsMean age was 65.5 years (SD = 8.7). Postoperatively, there was a significant improvement (p < 0.001) in WOMAC subscales of patient-reported pain, function, and stiffness, as well as EQ-5D-5L regardless of BMI group. Although, patients in BMI class II and class III reported significantly improved pain 3 months after TKA compared to those with normal BMI, all BMI groups attained similar level of pain reduction at 12 months after TKA. The greatest improvement in all WOMAC subscales, as well as EQ5D index, occurred between baseline and 3 months (adjusted p < 0.0001).ConclusionThe findings indicate that patients reported improved pain, function, and stiffness across all BMI groups following TKA. Patients with BMI classified as obese reported similar benefits to those with BMI classified as normal weight. These results may help health care providers to discuss expectations regarding the TKA recovery in terms of pain, function, and quality of life improvements with their TKA candidates.

Dataset Information

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

Background

Methods

Results

Conclusions

Publications

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

Similar Datasets

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