title: Achilles Tendon Repair in Obese Patients Is Associated With Increased Complication Rates.
abstract: Objective The objective of the present study is to utilize a national database to examine the association between obesity and postoperative complications after primary Achilles tendon repair. Methods The PearlDiver database was queried for patients undergoing primary Achilles repair using CPT 27650. Excision of a Haglund's deformity or tendon transfer were exclusion criteria. Patients were then divided into obese (body mass index [BMI] > 30 kg/m(2)) and nonobese (BMI < 30 kg/m(2)) cohorts using ICD-9 codes. Complications within 90 days postoperatively were assessed using ICD-9 and CPT codes. Results In all, 18 948 patients who underwent primary Achilles tendon repair were identified from 2005 to 2012. Overall, 2962 patients (15.6%) were coded as obese or morbidly obese. Obese patients had significantly higher rates of postoperative wound complications (odds ratio [OR] = 2.1; P < .0001), infection (OR = 1.8; P < .0001), venous thromboembolism (VTE; OR = 1.8; P = .001), and medical complications (OR = 3.9; P < .0001) compared with nonobese patients after primary Achilles tendon repair. Additionally, obese patients had a significantly lower rate of ankle stiffnesassociated with a significantly higher risk of s (OR = 0.4; P < .0001) compared with nonobese patients. Conclusion Obesity is associated with a significantly higher risk of wound complications, infection, VTE, and medical complications after primary Achilles tendon repair.
  
  
  METHODS
  Prognostic, Level II: Retrospective study.
authors.affiliation: Department of Orthopaedic Surgery (MTB, BCW), University of Virginia Health System, Charlottesville, VirginiaDivision Head, Foot and Ankle Service, Department of Orthopaedic Surgery (JSP), University of Virginia Health System, Charlottesville, VirginiaFoot and Ankle Service, Department of Orthopaedic Surgery (VP, MTC), University of Virginia Health System, Charlottesville, Virginia.
authors.forename: M Tyrrell
authors.initials: MT
authors.lastname: Burrus
authors.affiliation: Department of Orthopaedic Surgery (MTB, BCW), University of Virginia Health System, Charlottesville, VirginiaDivision Head, Foot and Ankle Service, Department of Orthopaedic Surgery (JSP), University of Virginia Health System, Charlottesville, VirginiaFoot and Ankle Service, Department of Orthopaedic Surgery (VP, MTC), University of Virginia Health System, Charlottesville, Virginia.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Werner
authors.affiliation: Department of Orthopaedic Surgery (MTB, BCW), University of Virginia Health System, Charlottesville, VirginiaDivision Head, Foot and Ankle Service, Department of Orthopaedic Surgery (JSP), University of Virginia Health System, Charlottesville, VirginiaFoot and Ankle Service, Department of Orthopaedic Surgery (VP, MTC), University of Virginia Health System, Charlottesville, Virginia.
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Park
authors.affiliation: Department of Orthopaedic Surgery (MTB, BCW), University of Virginia Health System, Charlottesville, VirginiaDivision Head, Foot and Ankle Service, Department of Orthopaedic Surgery (JSP), University of Virginia Health System, Charlottesville, VirginiaFoot and Ankle Service, Department of Orthopaedic Surgery (VP, MTC), University of Virginia Health System, Charlottesville, Virginia.
authors.forename: Venkat
authors.initials: V
authors.lastname: Perumal
authors.affiliation: Department of Orthopaedic Surgery (MTB, BCW), University of Virginia Health System, Charlottesville, VirginiaDivision Head, Foot and Ankle Service, Department of Orthopaedic Surgery (JSP), University of Virginia Health System, Charlottesville, VirginiaFoot and Ankle Service, Department of Orthopaedic Surgery (VP, MTC), University of Virginia Health System, Charlottesville, Virginia MTC2D@virginia.edu.
authors.forename: M Truit
authors.initials: MT
authors.lastname: Cooper
mesh_terms: D000125:Achilles Tendon / Q000293:injuries / Q000601:surgery*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D054556:Venous Thromboembolism / Q000453:epidemiology*
keywords: complications; infection; obesity; primary Achilles tendon repair; wound complications