Is obesity related with periprosthetic fractures around the knee?

Minarro, José Carlos; Urbano-Luque, Maria Teresa; Quevedo-Reinoso, Rafael; López-Pulido, Manuel Jesús; Fernández‐González, Ángel; Delgado-Martínez, A.D.

doi:10.1007/s00264-015-3071-5

Cited by 8 publications

(3 citation statements)

References 15 publications

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“…One additional article was identified from citation search and 210 full‐text articles were assessed for eligibility. Finally, 91 studies were included, with 22 prospective, 4,7,8,16,22–39 54 retrospective, 6,9–12,14,15,17,40–85 and 15 case‐controlled studies 5,13,18,19,86–96 …”

Section: Resultsmentioning

confidence: 99%

Greater risk of all‐cause revisions and complications for obese patients in 3 106 381 total knee arthroplasties: a meta‐analysis and systematic review

Onggo

Ang

Steiger

et al. 2021

ANZ Journal of Surgery

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Background Obesity is a major public health issue and has considerable implications on outcomes of total knee arthroplasty (TKA). However, there has been conflicting evidence and conclusions on the effects of obesity on TKA. This meta‐analysis compares the outcomes, complications, and peri‐operative parameters of TKA in the obese (body mass index [BMI] ≥ 30 kg/m2) versus non‐obese (BMI < 30 kg/m2) population as well as subgroup analysis of morbidly obese (BMI ≥ 40 kg/m2) versus non‐obese population. Methods A meta‐analysis was conducted with a multi‐database search according to PRISMA guidelines on 12 September 2019. Data from all published literature meeting inclusion criteria were extracted and analysed. Results Ninety‐one studies were included, consisting of 917 447 obese and 2 188 834 non‐obese TKA. Obese patients had higher risk of all‐cause revisions (odds ratio [OR] = 1.15, 95% CI: 1.08–1.24, p < 0.0001), all complications (OR = 1.21, 95% CI: 1.06–1.38, p = 0.004), deep infections (OR = 1.47, 95% CI: 1.27–1.69, p < 0.0001), superficial infections (OR = 1.59, 95% CI: 1.32–1.91, p < 0.0001), wound dehiscence (OR = 1.46, 95% CI: 1.24–1.72, p < 0.0001) and readmissions (OR = 1.21, 95% CI: 1.05–1.40, p = 0.009). Subgroup analysis of morbidly obese patients revealed greater risks of all‐cause revisions (OR = 1.25, 95% CI: 1.10–1.43, p = 0.0009), deep infections (OR = 1.98, 95% CI: 1.05–3.75, p = 0.04), superficial infections (OR = 2.44, 95% CI: 2.08–2.88, p < 0.0001) and readmissions (OR = 1.33, 95% CI: 1.20–1.47, p < 0.0001). No analysis was performed on patient reported outcome measures due to heterogeneous reporting methods. Conclusion Obese and morbidly obese patients have higher risks of revisions and infections post TKA. Surgeons should counsel patients of these risks during the informed consenting process and adopt preventative strategies into clinical practice to reduce risks where possible. In conclusion, obesity is a significant, modifiable risk factor for increased complications following TKA.

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Section: Resultsmentioning

confidence: 99%

Greater risk of all‐cause revisions and complications for obese patients in 3 106 381 total knee arthroplasties: a meta‐analysis and systematic review

Onggo

Ang

Steiger

et al. 2021

ANZ Journal of Surgery

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“…Ello justificaría la asociación del peso bajo a la presencia de fracturas por fragilidad 17,18 . La obesidad, al igual que en la literatura, no ha sido relacionada como un factor de riesgo 19 .…”

Section: Discussionunclassified

Factores de riesgo en fractura periprotésica femoral tras artroplastia sustitutiva primaria de rodilla

Redondo-Trasobares

Campos

Calvo-Tapies

et al. 2020

Revista Española de Cirugía Ortopédica y Traumatología

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Fractura periprotésica; Artroplastia total de rodilla; Factores de riesgo ResumenIntroducción y objetivos: Las fracturas periprotésicas tras artroplastia primaria de rodilla cobran gran importancia en nuestro medio debido tanto al aumento de su incidencia, como al reto que suponen para el cirujano. Múltiples factores se han asociado a su producción. El objetivo del estudio fue identificar los factores de riesgo que podían influir en la aparición de estas fracturas, cuáles de todos ellos son modificables y generar un modelo de predicción de probabilidad de las mismas en función de dichos factores. Material y método: Estudio analítico, observacional, retrospectivo, no pareado, de 38 casos de fracturas periprotésicas femorales de rodilla y 80 controles con prótesis de rodilla. En total, fueron incluidos en el estudio 118 pacientes, 83 mujeres y 35 hombres con una edad media de 72,49 años. Se recogieron datos sociodemográficos, antecedentes médicos y consumo de fármacos, así como los relativos a la cirugía. Se realizó un análisis uni-y bivariante de los factores determinantes de fractura, usando un modelo de regresión logística para evitar el sesgo de confusión. Resultados: De todos los factores estudiados según el modelo de regresión logística, se obtuvo que el sexo femenino (OR = 7,6), la demencia (OR = 5), la alteración motora/párkinson (OR = 19,3) y el sobrecorte femoral anterior (OR = 8,6) eran factores asociados al incremento de riesgo de este tipo de fracturas. Conclusiones: Este trabajo permite concluir que hay factores de riesgo, como son el sexo femenino, la demencia y el párkinson, que aumentan la probabilidad de fractura periprotésica, que son inherentes al paciente y no son modificables. Sin embargo, existe algún otro totalmente modificable que puede evitarse siendo exigente y exhaustivo en la técnica quirúrgica, como es el sobrecorte femoral anterior.

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“…8 Many other risk factors, that do not usually appear in a primary arthroplasty have been described in literature such as chronic intake of corticosteroids, rheumatoid arthritis, neurological disorders, and so on. [1][2][3][4]11 It is beyond the scope of this paper to discuss them all, so we will focus on the femoral notch.…”

Section: Discussionmentioning

confidence: 99%

Is the fracture pattern in periprosthetic fractures around the knee related with the anterior femoral notch?

Minarro

Urbano-Luque

López-Jordán

et al. 2018

Journal of Clinical Orthopaedics and Trauma

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Introduction: Periprosthetic fractures around the knee (PPF) are a devastating complication of total knee arthroplasty (TKA). Anterior femoral notching during TKA is considered a risk factor for PPF. The aim of this paper is to determine if an anterior femoral notch after total knee arthroplasty may affect the fracture pattern when a PPF appears postoperatively. Material and methods: 50 patients diagnosed in our centre of a PPF from January 2010 to December 2013 were retrospectively enrolled. 100 patients who underwent a total knee arthroplasty without fracture were randomly obtained as a control group. Evidence of the notch was searched in both groups in postoperative X-rays. In the PPF group, distance from the shield of the femoral component to the most distal (d) and proximal (D) point of the fracture were measured. Results: Two different groups were obtained: 1) d = 0 (33 out of 50 patients); the fracture is supposed to be related with the notch as it's a theoretically weaker area. 2) d > 0 (17 out of 50 patients); the fracture pattern has no relationship with the notch. Prevalence of patients suffering a fracture in the shield of the prosthesis (d = 0), was similar in both patients with notch (66,7%) and without it (68%). Conclusions: In conclusion, fracture pattern is not related with the existence of a femoral notch in the clinical setting.

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Is obesity related with periprosthetic fractures around the knee?

Abstract: As a conclusion, obesity (BMI ≥30 kg/m²) does not have any clinical relationship with the appearance of a periprosthetic fracture around the knee (p < 0.05).

Cited by 8 publications

References 15 publications

Greater risk of all‐cause revisions and complications for obese patients in 3 106 381 total knee arthroplasties: a meta‐analysis and systematic review

Greater risk of all‐cause revisions and complications for obese patients in 3 106 381 total knee arthroplasties: a meta‐analysis and systematic review

Factores de riesgo en fractura periprotésica femoral tras artroplastia sustitutiva primaria de rodilla

Is the fracture pattern in periprosthetic fractures around the knee related with the anterior femoral notch?

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