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. 2022 Aug 20:33:101987.
doi: 10.1016/j.jcot.2022.101987. eCollection 2022 Oct.

The impact of obesity on total knee arthroplasty outcomes: A retrospective matched cohort study

Vikram A Aggarwal  1 , Senthil N Sambandam  2 , Dane K Wukich  3
Affiliations

The impact of obesity on total knee arthroplasty outcomes: A retrospective matched cohort study

Vikram A Aggarwal et al. J Clin Orthop Trauma. .

Abstract

Background: Total Knee Arthroplasty (TKA) is a common orthopaedic surgery to treat advanced knee arthritis. Post-operative complications can be affected by obesity, defined as a body mass index of 30 kg/m2 or higher. We examine the rates of specific complications, revision rates, and costs of care following TKA and compare them between multifactor matched obese and non-obese patients. We hypothesize these outcomes will be worse in obese patients than in non-obese patients.

Methods: This retrospective study of the PearlDiver database queries for patients who underwent TKA under Current Procedural Terminology (CPT) and International Statistical Classification of Diseases (ICD-9) codes between January 2011 and January 2020. Patients were matched based on age, gender, and comorbidity indices, and various complications, revision rates, and costs were compared between the matched obese and non-obese patient groups.

Results: Obesity was associated with higher rates of surgical complications, such as wound complications, surgical site infections, need for revision, and higher total cost of care one year after TKA, and medical complications such as, acute kidney injury, deep vein thrombosis, urinary tract infection, and narcotics use, but significantly lower rates of anemia, arrhythmia, cardiac arrest, pneumonia, and transfusion. Obese patients also experienced significantly lower drug costs of care.

Conclusion: Outcomes were not definitively worse in obese patients when compared to matched non-obese patients. Nevertheless, understanding the complications that can arise following TKA will assist in educating patients about potential risks from surgery and guide surgeons in caring for their patients as obesity is predicted to continue increasing in prevalence. As such, future studies should examine underlying mechanisms that cause these complications to develop potential therapies.

Keywords: Comparison; Complications; Obesity; Retrospective database; Total knee arthroplasty.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Patient selection schematic based on CPT-27447.
Fig. 2
Fig. 2
Patient selection schematic based on ICD-9-P-8154.
See this image and copyright information in PMC

References

    1. Singh J.A., Yu S., Chen L., Cleveland J.D. Rates of total joint replacement in the United States: future projections to 2020-2040 using the national inpatient sample. J Rheumatol. 2019 Sep;46(9):1134–1140. doi: 10.3899/jrheum.170990. Epub 2019 Apr 15. PMID: 30988126. - DOI - PubMed
    1. Canovas F., Dagneaux L. Quality of life after total knee arthroplasty. Orthop Traumatol Surg Res. 2018 Feb;104(1S):S41–S46. doi: 10.1016/j.otsr.2017.04.017. Epub 2017 Nov 26. PMID: 29183821. - DOI - PubMed
    1. Delanois R.E., Mistry J.B., Gwam C.U., Mohamed N.S., Choksi U.S., Mont M.A. Current epidemiology of revision total knee arthroplasty in the United States. J Arthroplasty. 2017 Sep;32(9):2663–2668. doi: 10.1016/j.arth.2017.03.066. Epub 2017 Apr 6. PMID: 28456561. - DOI - PubMed
    1. Apovian C.M. Obesity: definition, comorbidities, causes, and burden. Am J Manag Care. 2016 Jun;22(7 Suppl):s176–s185. PMID: 27356115. - PubMed
    1. Kulkarni K., Karssiens T., Kumar V., Pandit H. Obesity and osteoarthritis. Maturitas. 2016 Jul;89:22–28. doi: 10.1016/j.maturitas.2016.04.006. Epub 2016 Apr 11. PMID: 27180156. - DOI - PubMed

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