Early complications of revision total knee arthroplasty in morbidly obese patients
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ORIGINAL ARTICLE • KNEE - ARTHROPLASTY
Early complications of revision total knee arthroplasty in morbidly obese patients Josh Carter1 · Bryan Springer1 · Brian M. Curtin1 Received: 29 December 2018 / Accepted: 18 February 2019 © Springer-Verlag France SAS, part of Springer Nature 2019
Abstract Introduction Morbid obesity is a known risk factor for complications and failure following primary total knee arthroplasty. Complications following revision total knee arthroplasty (rTKA) in the morbidly obese (BMI > 40) have not been well described. A retrospective cohort study was designed to investigate the early complications of rTKA in morbidly obese patients. Methods Revision TKA procedures were performed between January 2009 and December 2012 at a single institution. Comparisons were made between patients with a normal BMI (18.5–25) and patients with morbid obesity (BMI > 40). Results Thirty-three of 141 morbidly obese patients (23.4%) had a complication compared to 10 of 96 patients with a BMI 18.5–25 (10.4%) (p = 0.011). Morbidly obese patients were younger (69.3 vs. 61.4 years, p 40) on rTKA has not been as clearly described. Some studies suggest that body mass index (BMI) has no significant effect on complications * Brian M. Curtin [email protected] 1
OrthoCarolina Hip and Knee Center, 2001 Vail Avenue, Ste 200A, Charlotte, NC 28207, USA
after rTKA [7]. Others have reported rates of re-revision after rTKA as high as 2.9 times greater in patients with a BMI > 40 compared to rTKA patients who are not morbidly obese [8]. Morbid obesity is associated with an increased risk of moderate–severe functional limitations [9]. Kasmire et al. [10] showed that BMI had an impact on postoperative function and range of motion (ROM) after rTKA as assessed by The Western Ontario and McMaster Universities Arthritis Index (WOMAC). Similarly, Pulos et al. reported on the effect of obesity (BMI > 35) on revision total hip arthroplasty, noting that complications, infection, re-admission, and re-operation were significantly increased in this group [11]. More recently, a review of 93 morbidly obese patients undergoing rTKA were shown to have a significantly higher revision, re-operation, and infection rate than a comparative group with normal BMI at a minimum 5-year follow-up [12]. Much emphasis is now being placed on identifying early complications in an effort to limit readmissions. The purpose of this cohort study is to determine (1) Is the rate of early complications after revision TKA increased in the morbidly obese patient population compared to patients with normal
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BMI? and (2) Which complications are the most frequent in the morbidly obese population after revision TKA?
Methods Using our institutional database, a retrospective cohort study was designed to investigate the early complications of rTKA procedures. All patients who underwent rTKA between January 2007 and December 2012 at our institution were included. A minimum of 2 years of follow-up was required. These patients were
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