Obesity May Impair the Early Outcome of Total Knee Arthroplasty a Prospective Study of 100 Patients

Järvenpää, Jaakko; Kettunen, Jukka; Kröger, Heikki; Miettinen, Hannu

doi:10.1177/145749691009900110

Cited by 90 publications

(52 citation statements)

References 24 publications

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“…Our findings may be surprising considering that many orthopaedic surgeons hesitate to operate on obese patients who are prone to higher risks of component failures and worse outcomes [2,22]. Several recent studies [9,10,14,27] have examined the impact of obesity on function of TKA (Table 5). Although some authors reported no differences in the function between nonobese and obese patients during short-term and long-term followups [9,27], others have reported that severely obese patients had poorer function [10,18].…”

Section: Discussionmentioning

confidence: 87%

“…Fourth, we did not report complications and cannot comment on this issue. However, several studies [2,14,19,21] have reported obese patients had a higher number of perioperative complications.…”

Section: Discussionmentioning

confidence: 99%

“…Concurring with Dewan et al [9] and Stevens-Lapsley et al [27], we did not find that BMI negatively influenced ROM or function after conventional TKA. Järvenpää et al [14] prospectively studied 100 patients undergoing TKAs and compared ROM and function between two BMI-stratified groups. They found obese patients had worse ROM at 3 months compared with nonobese patients, echoing our ROM findings at 6 months.…”

Section: Discussionmentioning

confidence: 99%

“…There have been several papers [9,14,27] to date discussing the impact of obesity on postoperative outcomes after TKAs in Western patients. Given the fact that obesity-related complications occur at a lower BMI in Asian as compared with the Western population, Asia could see a greater number of obese patients consulting orthopaedic surgeons for TKAs.…”

Section: Introductionmentioning

confidence: 99%

“…Although Western studies [12,14] show the deleterious effects of obesity on postoperative outcomes after conventional TKAs, studies on Asian patients are few and inconclusive. With the advent of globalization and migrant communities throughout the world, it is important surgeons know the peculiar characteristics of a patient from a particular community so that the ideas, concerns, and expectations of the patient are addressed.…”

Section: Introductionmentioning

confidence: 99%

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Obesity Does Not Imply Poor Outcomes in Asians after Total Knee Arthroplasty

Razak

Chong

Tan

2013

Clinical Orthopaedics &Amp; Related Research

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Background In Asia, obesity has reached epidemic proportions and physicians are likely to face a burden of obesity-related disorders, of which osteoarthritis of the knee is one. However, it is unclear whether obesity affects improvement of conventional TKAs in Asian patients. Purpose We therefore asked whether obese patients with a BMI of 30 kg/m 2 or greater would have worse ROM and function after TKA compared with their nonobese counterparts and whether they would have less improvement preoperatively to postoperatively. Methods

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Obesity Does Not Imply Poor Outcomes in Asians after Total Knee Arthroplasty

Razak

Chong

Tan

2013

Clinical Orthopaedics &Amp; Related Research

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Body Mass Index and Functional Mobility Outcome Following Early Rehabilitation After a Total Knee Replacement: A Retrospective Study in Taiwan

Liao

Huang

et al. 2015

Arthritis Care & Research

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ObjectiveObesity is associated with an increased risk of osteoarthritis, and the incidence of obese patients requiring a total knee replacement (TKR) has increased in recent years. A high body mass index (BMI) may influence post‐TKR rehabilitation outcomes. We investigated the effects of obesity on functional mobility outcomes following post‐TKR rehabilitation in Asian patients whose BMIs were not as high as those reported in similar studies performed in non‐Asian countries.MethodsA total of 113 patients were categorized as normal weight (n = 23), overweight (n = 32), class I obese (n = 31), or class II/III obese (n = 27). Patients were retrospectively followed up for 6 months after undergoing TKR followed by 2 months of active rehabilitation. Outcome measures were recorded at baseline and at the 2‐month and 6‐month followup assessments and included the Western Ontario and McMaster Universities Osteoarthritis Index and the following tests: functional reach, single‐leg stance, ten‐meter walk, timed up and go, chair rise, and stair climbing.ResultsA 4 × 3 (group × time) repeated‐measures analysis of variance showed significant improvement in all of the outcome measures for all of the BMI groups at the 2‐month and 6‐month followup assessments (P < 0.05 for all). No significant intergroup differences at the 2‐month and 6‐month followup assessments were observed for any of the mobility measures except the functional reach and single‐leg stance (P < 0.05).ConclusionPatients with class II/III obesity benefit from early post‐TKR outpatient rehabilitation and respond as well as patients with lower BMIs.

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Patients’ Preoperative Expectations of Total Knee Arthroplasty and Satisfaction With Outcomes at One Year: A Prospective Cohort Study

Hawker

Conner‐Spady

Bohm

et al. 2020

Arthritis & Rheumatology

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Objective To assess the relationship between patients’ expectations for total knee arthroplasty (TKA) and satisfaction with surgical outcome. Methods This prospective cohort study recruited patients with knee osteoarthritis (OA) ages ≥30 years who were referred for TKA at 2 hip/knee surgery centers in Alberta, Canada. Those who received primary, unilateral TKA completed questionnaires pre‐TKA to assess TKA expectations (17‐item Hospital for Special Surgery [HSS] TKA Expectations questionnaire) and contextual factors (age, sex, Western Ontario and McMaster Universities Osteoarthritis Index pain score, Knee Injury and Osteoarthritis Outcome Score physical function short form [KOOS‐PS], 8‐item Patient Health Questionnaire depression scale, body mass index [BMI], comorbidities, and prior joint replacement), and 1‐year post‐TKA to assess overall satisfaction with TKA results. Using multivariate logistic regression, we examined the relationship between TKA expectations (HSS TKA outcomes considered to be very important) and postoperative satisfaction (very satisfied versus somewhat satisfied versus dissatisfied). Adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. Results At 1 year, 1,266 patients with TKA (92.1%) reported their TKA satisfaction (mean ± SD age 67.2 ± 8.8 years, 60.9% women, and mean BMI 32.6 kg/m2); 74.7% of patients were very satisfied, 17.1% were somewhat satisfied, and 8.2% were dissatisfied. Controlling for other factors, an expectation of TKA to improve patients’ ability to kneel was associated with lower odds of satisfaction (adjusted OR 0.725 [95% CI 0.54–0.98]). An expectation of TKA to improve psychological well‐being was associated with lower odds of satisfaction for individuals in the lowest tertile of pre‐TKA KOOS‐PS scores (adjusted OR 0.49 [95% CI 0.28–0.84]), but higher odds for those in the highest tertile (adjusted OR 2.37 [95% CI 1.33–4.21]). Conclusion In patients with TKA, preoperative expectations regarding kneeling and psychological well‐being were significantly associated with the level of TKA satisfaction at 1 year. Ensuring that patients’ expectations are achievable may enhance appropriate provision of TKA.

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Obesity May Impair the Early Outcome of Total Knee Arthroplasty a Prospective Study of 100 Patients

Abstract: We suggest that obesity may impair the early outcome of total knee arthroplasty and obese patients should be informed about the increased risk of complications related to TKA. Key words: Total knee arthroplasty; body mass index; obesity; complications; range of motion; mechanical axis.

Cited by 90 publications

References 24 publications

Obesity Does Not Imply Poor Outcomes in Asians after Total Knee Arthroplasty

Obesity Does Not Imply Poor Outcomes in Asians after Total Knee Arthroplasty

Body Mass Index and Functional Mobility Outcome Following Early Rehabilitation After a Total Knee Replacement: A Retrospective Study in Taiwan

Patients’ Preoperative Expectations of Total Knee Arthroplasty and Satisfaction With Outcomes at One Year: A Prospective Cohort Study

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