This article is more than 5 years old. Information may no longer be current.
Morbid obesity decreases efficacy of TKA, study finds
Investigators urge patients to lose weight before proceeding with surgery or undergo preoperative counseling about inferior results.
Click Here to Manage Email Alerts
GLASGOW, Scotland — Morbidly obese patients who undergo total knee arthroplasty achieve inferior postop Knee Society Scores and have a higher perioperative complication rate compared to patients of normal weight, a prospective study by British researchers found.
Anish Amin, FRCS, and colleagues at the Queen Margaret Hospital in Dunfermline, Scotland, evaluated the results of TKA performed on 41 consecutive patients with morbid obesity, defined as a Body Mass Index (BMI) over 40. They compared the results to those of 41 TKAs performed in nonobese patients with a BMI less than 30.
Amin presented the results here at the 2006 British Orthopaedic Association Annual Congress. Patients in both groups were matched for age, sex, diagnosis, prosthesis, laterality and preoperative Knee Society Score, he noted.
At less than 4 years follow-up, the researchers found that the morbidly obese patient group exhibited a higher incidence of radiolucent lines as well as inferior 5-year survivorship, according to the study.
The results suggest that morbid obesity places greater strain on patients' new joint prostheses and the surrounding healing tissue. This increased strain impacts the overall healing process and can result in a higher complication rate, Amin said.
Ultimately, orthopaedic surgeons must make sensitive decisions regarding the care of obese patients, he added.
"Results of [TKA] in morbidly obese patients are poor and these patients should lose weight, or be counseled regarding the inferior results before proceeding with [surgery]," the authors said in the abstract.
"We must decide: Should we refuse [TKA] surgery for patients with a BMI above 40?" Amin said. "I know that if there is a good chance that these [obese] patients will have difficulties later on, I [encourage] them to lose weight before getting surgery."
For more information:
- Amin AK, Clayton R, Gaston M, et al. Total knee replacement in morbidly obese patients: results of a prospective, matched study. Presented at the 2006 British Orthopaedic Association Annual Congress. Sept. 27-29, 2006. Glasgow, Scotland.