DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20172873

Assessment of total knee replacement in obese patients and nonobese patients: a comparative study

Dipak Suthar, Tushar Vegad

Abstract


Background: The present study was carried out with the objective to assess the influence of morbid obesity on the outcome after TKR and with the aim to compare the outcome following TKR in a consecutive series of morbidly obese patients (BMI >40 kg/m2), and matched it with group of non-obese patients (BMI <30 kg/m2).

Methods: The study period planned was of two years. The totals of 100 patients undergoing total knee replacement were selected for the study period. On the basis of body mass index inclusion criteria for the two groups were decided. Of the total 100 patients, they were divided into two groups. One group 1 consisted of obese patients with total of 50 patients and group 2 consisted of non-obese patient with total of 50 patients.

Results: At the end of two years when the data was compared with the preoperative assessment, it was found to significantly better where value of p was <0.001.  However when the comparison was done between the two groups, it was found that scores were lower in the group 1 patients which included the obese patients.

Conclusions: Total knee arthroplasty is a safe and efficacious operation in obese patients with no significantly greater risk of complications. However, post-operative clinical scores and absolute improvement in the scores are statistically superior in non-obese patients at one year follow-up. Obese patients should be started on weight loss programs and counselled about possible inferior results for total knee replacement. 


Keywords


Evaluations, Obesity, Total knee replacement

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References


Caprini JA. Risk assessment as a guide for the prevention of the many faces of venous thromboembolism. Am J Surg. 2010;199:3-10.

Dixon JB, Zimmet P, Alberti K, Rubino F. Bariatric surgery: an IDF statement for obese Type 2 diabetes. Diabetic Medicine. 2011;28:628-42.

Paladini D. Sonography in obese and overweight pregnant women: clinical, medicolegal and technical issues. Ultrasound Obstetrics Gynecol. 2009;33:720-9.

Brugioni DJ, Falkel J. Total Knee Replacement and Rehabilitation. The Knee Owner's Manual: Hunter House; 2004.

Topol E. The creative destruction of medicine: How the digital revolution will create better health care. Basic Books; 2013.

Bradford DS, Zdeblick TA. The spine. Lippincott Williams & Wilkins; 2004.

Metsna V. Anterior knee pain in patients following total knee arthroplasty: the prevalence, correlation with patellar cartilage impairment and aspects of patellofemoral congruence. 2015.

Richter M, Trzeciak T, Owecki M, Pucher A, Kaczmarczyk J. The role of adipocytokines in the pathogenesis of knee joint osteoarthritis. Int Orthopaed. 2015;39:1211-7.

Muthuri SG, Hui M, Doherty M, Zhang W. What if we prevent obesity? Risk reduction in knee osteoarthritis estimated through a meta‐analysis of observational studies. Arthritis Care Res. 2011;63:982-90.

Iannone F, Lapadula G. Obesity and inflammation-targets for OA therapy. Current Drug Targets. 2010;11:586-98.

Lübbeke A, Moons KG, Garavaglia G, Hoffmeyer P. Outcomes of obese and nonobese patients undergoing revision total hip arthroplasty. Arthritis Care Res. 2008;59:738-45.

Ayyar V. The influence of Obesity on outcomes following Total Knee Arthroplasty. Queen Margaret University, 2012.