Effects of body mass index on outcomes of total knee arthroplasty
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ORIGINAL ARTICLE
Effects of body mass index on outcomes of total knee arthroplasty Koray Başdelioğlu1 Received: 1 July 2020 / Accepted: 30 October 2020 © Springer-Verlag France SAS, part of Springer Nature 2020
Abstract Purpose The aim of this study was to group the patients with total knee arthroplasty(TKA) surgery according to the World Health Organization (WHO) obesity classification and to evaluate the effects of body mass index (BMI) on complication rates, the functional and clinical outcomes of the patients after TKA. Methods Between 2011 and 2018, 588 patients who underwent TKA by a single surgeon were retrospectively evaluated. According to WHO’s classification criteria, 588 patients were divided into 5 groups such as normal ( 40 kg/m2 n: 43 7.6%). Groups were compared in terms of age, sex, surgical side, follow-up period, case duration, prosthesis infection and aseptic prosthesis loosening rates, Knee Injury and Osteoarthritis Outcome Score (KOOS), Lysholm functional scores and knee flexion degrees. Results There was a statistically significant difference between the groups in terms of prosthesis infection or aseptic prosthesis loosening following TKA. The incidence of these complications increased as BMI increased (X2: 20,079, p: 0.01). Postoperative knee flexion degrees, KOOS and Lysholm scores were significantly different between the groups (p: 0.000). As BMI increased, clinical and functional outcomes deteriorated. Conclusion Obesity is one of the most important risk factors for prosthesis infection and aseptic prosthesis loosening which can be seen after TKA. High BMI values also adversely affect clinical and functional outcomes after TKA. Keywords Total knee arthroplasty · Obesity · Body mass index · Prosthesis infection · Aseptic prosthesis loosening
Introduction Obesity is one of the most important health problems worldwide [1]. In 2000, the World Health Organization (WHO) developed a classification system for obesity in which weight and height were evaluated together. According to this system, body mass index (BMI) of 18.5–24.9 kg/m2 is defined normal weight, 25.0–29.9 kg/m2 is defined overweight or preobese, 30.0–34.9 kg/m2, 35.0–39.9 kg/m2 and > 40.0 kg/ m2 and these are defined, respectively, with class I obese, class II obese and class III obese [2]. According to the data published by WHO in 2018, obesity has increased threefold worldwide since 1975. The report states that 1.9 billion(39%) people over 18 years of age are overweight * Koray Başdelioğlu [email protected] 1
Istanbul Oncology Hospital Department of Orthopaedic and Traumatology, Cevizli Mah. Toros Cad. No :86 Maltepe, Istanbul, Turkey
(BMI: 25.0–29.9 kg/m2) and 650 million (13%) are obese (BMI: > 30 kg/m2). Many studies revealed a strong relationship between obesity and the development of osteoarthritis [3–5]. In obese patients, the risk of developing osteoarthritis of the knee increases by 9–13% per weight added to body mass. This rate increases up to 35% with each 5 kg of weight gain [6]. The number of overweig
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