The outcomes of total knee arthroplasty in morbidly obese patients: a systematic review of the literature

Autor: Steven Millington, Sammy A. Hanna, Louis Boyce, Matthew C. Barrett, Pramod Achan, Sebastian Dawson-Bowling, Anoop Prasad
Rok vydání: 2018
Předmět:
Quality of life
medicine.medical_specialty
Complications
Knee Society Functional scores
Superficial wound infection
Total knee arthroplasty
Non-obese
Knee Society Objective scores
Morbidly obese
KSFS
Revision rate
Cohort Studies
Morbid obesity
03 medical and health sciences
Complication rates
0302 clinical medicine
Statistical significance
Internal medicine
Medicine
Humans
Orthopedics and Sports Medicine
Obesity
Wound healing problems
Knee Arthroplasty
Arthroplasty
Replacement
Knee
KSOS
030222 orthopedics
business.industry
TKA
030229 sport sciences
General Medicine
Perioperative
Functional outcome
medicine.disease
Obesity
Morbid
Total knee replacement
Treatment Outcome
Cohort
TKR
Surgery
Prosthetic infection
business
Complication
Infection
Wound healing delay
Body mass index
Infection rates
Zdroj: Archives of Orthopaedic and Trauma Surgery
ISSN: 1434-3916
Popis: Introduction The increasing prevalence of obesity has led to an increase in total knee arthroplasties (TKAs) being undertaken in patients with a higher body mass index (BMI). TKA in morbidly obese patients can be technically challenging due to numerous anatomical factors and patient co-morbidities. The long-term outcomes in this patient group are unclear. This systematic review aims to compare the long-term revision rates, functional outcomes and complication rates of TKAs in morbidly obese versus non-obese patients. Methods A search of PubMed, EMBASE and PubMed Central was conducted to identify studies that reported revision rates in a cohort of morbidly obese patients (BMI ≥ 40 kg/m2) that underwent primary TKA, compared to non-obese patients (BMI ≤ 30 kg/m2). Secondary outcomes included Knee Society Objective Scores (KSOS), Knee Society Functional Scores (KSFS), and complication rates between the two groups. The difference in revision rates was assessed using the Chi-squared test. The Wilcoxon signed-rank test was used to compare pre-operative and post-operative functional scores for each group. KSOS and KSFS for morbidly obese and non-obese patients were compared using the Mann–Whitney test. Statistical significance was defined as p ≤ 0.05. Results Nine studies were included in this review. There were 624 TKAs in morbidly obese patients and 9,449 TKAs in non-obese patients, average BMI values were 45.0 kg/m2 (range 40–66 kg/m2) and 26.5 kg/m2 (range 11–30 kg/m2) respectively. The average follow-up time was 4.8 years (range 0.5–14.1) and 5.2 years (range 0.5–13.2) respectively, with a revision rate of 7% and 2% (p
Databáze: OpenAIRE
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