A comparison of outcomes in morbidly obese, obese and non-obese patients undergoing primary total knee and total hip arthroplasty.

Autor: Deakin AH; Department of Orthopaedics, Golden Jubilee National Hospital, Agamemnon Street, Clydebank, G81 4DY, United Kingdom. Electronic address: angela.deakin@gjnh.scot.nhs.uk., Iyayi-Igbinovia A; Department of Orthopaedics, Golden Jubilee National Hospital, Agamemnon Street, Clydebank, G81 4DY, United Kingdom., Love GJ; Department of Orthopaedics, Golden Jubilee National Hospital, Agamemnon Street, Clydebank, G81 4DY, United Kingdom.
Jazyk: angličtina
Zdroj: The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland [Surgeon] 2018 Feb; Vol. 16 (1), pp. 40-45. Date of Electronic Publication: 2017 Jan 27.
DOI: 10.1016/j.surge.2016.10.005
Abstrakt: Background: Obesity is a growing public health issue with the prevalence of morbid obesity, (Body Mass Index (BMI) ≥ 40 kg/m 2 ) 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.
Method: 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.
Conclusion: 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.
(Copyright © 2016 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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