title: A comparison of outcomes in morbidly obese, obese and non-obese patients undergoing primary total knee and total hip arthroplasty.
abstract: BACKGROUND
  Obesity is a growing public health issue with the prevalence of morbid obesity, (Body Mass Index (BMI) ≥ 40 kg/m2) increasing. There is some evidence these patients have more peri- and post-operative complications and poorer outcomes when undergoing arthroplasty procedures. This audit aimed to determine and compare the outcomes of non-obese, obese and morbidly obese patients undergoing arthroplasty at our institution.
  
  
  METHODS
  This was a retrospective audit of patients from our institution who had undergone total knee (TKA) or total hip arthroplasty (THA) in 2009. Data collected were: age, gender, BMI, length of stay (LOS), Oxford knee or hip score (OKS/OHS), satisfaction and complications up to two years post operation. Patients were divided into three groups: BMI < 30, BMI 30-40 and BMI > 40. Outcomes for each BMI group were compared.
  
  
  RESULTS
  1014 TKA and 906 THA operations were included. When compared to obese and non-obese patients, morbidly obese patients undergoing TKA had a mean LOS one day longer, a mean OKS four points lower and higher rates of postoperative problems, 37% vs. 21%. For THA patients there was no difference in LOS, OHS score was two points lower for each increasing BMI category and postoperative problems increase from 25% for non-obese to 31% for obese and 38% for morbidly obese patients.
  
  
  CONCLUSIONS
  These results will be useful in informing obese patients of their potential outcomes following TKA or THA. These patients can then make a more informed choice before proceeding with arthroplasty.
authors.affiliation: Department of Orthopaedics, Golden Jubilee National Hospital, Agamemnon Street, Clydebank, G81 4DY, United Kingdom. Electronic address: angela.deakin@gjnh.scot.nhs.uk.
authors.forename: Angela H
authors.initials: AH
authors.lastname: Deakin
authors.affiliation: Department of Orthopaedics, Golden Jubilee National Hospital, Agamemnon Street, Clydebank, G81 4DY, United Kingdom.
authors.forename: Aghimien
authors.initials: A
authors.lastname: Iyayi-Igbinovia
authors.affiliation: Department of Orthopaedics, Golden Jubilee National Hospital, Agamemnon Street, Clydebank, G81 4DY, United Kingdom.
authors.forename: Gavin J
authors.initials: GJ
authors.lastname: Love
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000706:statistics & numerical data*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D006621:Hip Joint / Q000601:surgery; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D009767:Obesity, Morbid / Q000150:complications; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Complications; Morbid obesity; Patient satisfaction; Total hip arthroplasty; Total knee arthroplasty