Outcomes of Total Knee Arthroplasty Revisions in Obese and Morbidly Obese Patient Populations |
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| Affiliation: | 1. Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson, Mississippi;2. Department of Orthopaedics, University of Missouri, Columbia, Missouri;3. Department of Orthopedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas;1. Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas;2. Department of Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas;3. Arkansas Department of Health, Little Rock, Arkansas;1. Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh;2. Department of Orthopaedics, University of Edinburgh, Edinburgh;3. Golden Jubilee National Hospital, Glasgow;4. School of Health and Life Sciences, Glasgow Caledonian University, Glasgow;1. OrthoCarolina Hip and Knee Center, Atrium Musculoskeletal Institute, Charlotte, North Carolina;2. Covenant Physician Partners, Nashville, Tennessee;3. Department of Orthopedic Surgery, Stanford University School of Medicine, Palo Alto, California;1. Department of Orthopaedic Surgery, Newton-Wellesley Hospital, Newton, Massachusetts;2. Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts;1. Department of Orthopaedic Surgery, Stanford University, Redwood City, California;2. Stanford University School of Medicine, Stanford, California;1. Department of Orthopaedic Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania;2. Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland;3. Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland |
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| Abstract: | BackgroundThe obese population is at higher risk for complications following primary total knee arthroplasty (TKA), but little data is available regarding revision outcomes. This study aimed to investigate the role of body mass index (BMI) in the cause for revision TKA and whether BMI classification is predictive of outcomes.MethodsA multi-institutional database was generated, including revision TKAs from 2012 to 2019. Data collection included demographics, comorbidities, surgery types (primary revision, repeat revision), reasons for revision, lengths of hospital stay, and surgical times. Patients were compared using 3 BMI categories: nonobese (18.5 to 29.9), obese (30 to 39.9), and morbidly obese (≥40). Categorical and continuous variables were analyzed using chi-square and 1-way analysis of variance tests, respectively. Regression analyses were used to compare reasons for revision among weight classes.ResultsObese and morbidly obese patients showed significant risk for repeat revision surgery in comparison to normal weight patients. Obese patients were at higher risk for primary revision due to stiffness/fibrosis and repeat revision due to malposition. In comparison to the obese population, morbidly obese patients were more likely to require primary revision for dislocation and implant loosening.ConclusionSignificant differences in primary and repeat revision etiologies exist among weight classes. Furthermore, obese and morbidly obese patients have a greater risk of requiring repeat revision surgery. These patients should be informed of their risk for multiple operations, and surgeons should be aware of the differences in revision etiologies when anticipating complications following primary TKA. |
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| Keywords: | obesity revision total knee arthroplasty total knee arthroplasty failure total knee arthroplasty outcomes rerevision |
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