Effect of body mass index on functional outcome in primary total knee arthroplasty-a single institution analysis of 2180 primary total knee replacements

• 作者: Adam Daly Darren F Lui Joseph S Butler Patrick Kenny Shane C O’Neill
• 来源期刊: 世界骨科杂志
• 学科: 医学
• 关键词: TOTAL KNEE REPLACEMENT Body mass index TOTAL KNEE ARTHROPLASTY
• 年，卷（期）: 2016,（10）
• 页码范围: 664-669
• 页数: 6页
• 分类号: R

摘要

AIM To evaluate the effect of body mass index(BMI)on short-term functional outcome and complications in primary total knee arthroplasty.METHODS All patients undergoing primary total knee arthroplasty at a single institution between 2007 and 2013 were identified from a prospective arthroplasty database.2180 patients were included in the study.Age,gender,BMI,pre-and post-operative functional scores[Western Ontario and McMaster University Arthritis Index(WOMAC)and SF-36],complications and revision rate were recorded.Patients were grouped according to the WHO BMI classification.The functional outcome of the normal weight cohort(BMI<25)was compared to the overweight and obese(BMI≥25)cohort.A separate sub-group analysis was performed comparing all five WHO BMI groups;Normal weight,overweight,class 1 obese,class 2 obese and class 3 obese.RESULTS With a mean age of 67.89(28-92),2180 primary total knee replacements were included.64.36%(1403)were female.The mean BMI was 31.86(18-52).Ninty-three percent of patients were either overweight or obese.Mean follow-up 19.33 mo(6-60 mo).There was no significant difference in pre or post-operative WOMAC score in the normal weight(BMI<25)cohort compared to patients with a BMI≥25(P>0.05).Sub-group analysis revealed significantly worse WOMAC scores in class 2 obese 30.80 compared to overweight 25.80(P<0.01)and class 1 obese 25.50(P<0.01).Similarly,there were significantly worse SF-36 scores in class 2 obese 58.16 compared to overweight 63.93(P<0.01)and class 1 obese 63.65(P<0.01)There were 32(1.47%)superficial infections,9(0.41%)deep infections and 19(0.87%)revisions overall with no complications or revisions in the normal weight cohort(BMI<25).CONCLUSION Post-operative functional outcome was not influenced by BMI comparing normal weight individuals with BMI>25.Patients should not be denied total knee arthroplasty based solely on weight alone.