Obesity and Perioperative Morbidity in Total Hip and Total Knee Arthroplasty Patients

Obese Diabetic Patients are at Substantial Risk for Deep Infection after Primary TKA

“…We were surprised by the paucity of studies which report specifically on the incidence of acute periprosthetic infection for obese patients after primary TKA and even fewer that review the combined effect of comorbidities with obesity [1,16,17,19,25]. In the current study, we also analyzed other patient and surgical variables also reported to correlate with prosthetic infection.…”

Percent Body Fat More Associated with Perioperative Risks After Total Joint Arthroplasty Than Body Mass Index

“…One notable exception was the dramatically higher rate of increased LOS N3 days for the obese by PBF (66.9%) compared to obese by BMI (32.2%). Several recent studies have also demonstrated the importance of obesity BMI thresholds associated with increased complications and increased LOS [12,14]. Although PBF does not further sub-classify obese from morbidly obese patients by definition, the results appear to show higher postoperative complication rates in the obese group as defined by the current PBF classification system.…”

“…The majority of the current literature would indicate higher perioperative complication rates following TJA in the obese population including longer operative times, increased wound complications/infections, and increased hospital length of stay (LOS) and cost [11][12][13][14]. However, obesity risk assessment is a complicated condition that is compounded by other associated major comorbidities (diabetes mellitus, hypertension, coronary artery disease) that independently increase surgical risk [15].…”

Chronic renal failure due to amyloid nephropathy caused by chronic infection after total hip replacement

“…Infection is reported to be a frequent cause of surgical failure after joint replacement surgery, and THR revision surgery is required in 7-16 % of cases to treat the infection [23]. Several studies indicate that obesity [24] and superficial and deep infections [25] cause infection after THR. Prolonged inflammation after orthopedic surgery can cause secondary amyloidosis, which may in turn result in end-stage renal failure.…”