title: Does obesity influence clinical outcome at nine years following total knee replacement?
abstract: A total of 445 consecutive primary total knee   replacements (TKRs) were followed up prospectively at six and 18 months   and three, six and nine years. Patients were divided into two groups:   non-obese (body mass index (BMI) < 30 kg/m(2)) and obese   (BMI ≥ 30 kg/m(2)). The obese group was subdivided into   mildly obese (BMI 30 to 35 kg/m(2)) and highly obese (BMI ≥ 35   kg/m(2)) in order to determine the effects of increasing   obesity on outcome. The clinical data analysed included the Knee   Society score, peri-operative complications and implant survival.   There was no difference in the overall complication rates or implant   survival between the two groups. Obesity appears to have a small but significant adverse effect   on clinical outcome, with highly obese patients showing lower function   scores than non-obese patients. However, significant improvements   in outcome are sustained in all groups nine years after TKR. Given   the substantial, sustainable relief of symptoms after TKR and the low   peri-operative complication and revision rates in these two groups,   we have found no reason to limit access to TKR in obese patients.
authors.affiliation: University of Edinburgh College of Medicine & Veterinary Medicine, Chancellor's Building, Little France, Edinburgh, EH14 6SA, UK. r.a.collins@sms.ed.ac.uk
authors.forename: R A
authors.initials: RA
authors.lastname: Collins
authors.forename: P J
authors.initials: PJ
authors.lastname: Walmsley
authors.forename: A K
authors.initials: AK
authors.lastname: Amin
authors.forename: I J
authors.initials: IJ
authors.lastname: Brenkel
authors.forename: R A E
authors.initials: RA
authors.lastname: Clayton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D020370:Osteoarthritis, Knee / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome