Implant durability and knee function after total knee arthroplasty in the morbidly obese patient.
This study investigated the effect of body mass index (BMI) on outcomes after cemented tricompartmental total knee arthroplasty (TKA). Functional and radiographic Knee Society scores in 71 patients (94 knees) with BMI 30 to 39 and 31 patients (41 knees) with BMI > or =40 were compared with 67 patients (85 knees) with BMI 20 to 29 at a mean follow-up of 5.4 years. Total knee arthroplasty rates of success (79%), complication (17%), and revision (6%) were independent of BMI. The BMI > or =40 group, however, was 5.4x (95% confidence interval, 2.1-14.7) more likely to develop patellar radiolucencies, had poorer hamstring and quadriceps conditioning, and had more patellofemoral symptoms. Forty percent of TKAs at BMI > or =40 with patellar radiolucencies failed. In conclusion, TKA benefits were realized at all BMI, but at BMI > or =40, more rehabilitation and monitoring are recommended.
Dewan
Ashvin
A
Baylor College of Medicine, Houston, Texas, USA.
Bertolusso
Roberto
R
Karastinos
Anatassios
A
Conditt
Michael
M
Noble
Philip C
PC
Parsley
Brian S
BS
D001741:Black or African American; D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006630:Hispanic or Latino; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000502:physiology* / Q000601:surgery; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000503:physiopathology*; D011475:Prosthesis Failure; D011859:Radiography; D020127:Recovery of Function; D016896:Treatment Outcome; D044465:White People