March 06, 2018
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Increased BMI yielded greater risk of readmission, complications after TKA

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Results showed an increased risk of readmission and various complications after total knee arthroplasty among patients who were obese, with the severity of obesity determining the risk, according to results.

Anton A. Khlopas, MD, and colleagues compared 30-day rates of readmissions, reoperations and medical/surgical complications between patients who underwent TKA from 2011 to 2015 and were identified as normal weight, overweight, obese or morbidly obese.

Results showed an increased risk of pulmonary embolism among patients who were obese. Researchers also found an increased risk of readmission, reoperation, superficial infection, periprosthetic joint infection, wound dehiscence, pulmonary embolism, urinary tract infection, reintubation and renal insufficiency among patients who were morbidly obese. Patients who were overweight, obese and morbidly obese had a lower transfusion rate compared with patients who were normal weight. Researchers noted a non-linear relationship between BMI with readmission, reoperation, periprosthetic joint infection, pulmonary embolism, renal insufficiency and transfusion.

“Our study found that BMI and various complications after total knee arthroplasty may have a non-linear relationship,” Khlopas told Healio.com/Orthopedics. “Complications such as readmission, reoperation and prosthetic joint infection had a U-shaped relationship with BMI, with the lowest risk of complications found in patients with BMI about 29 kg/m2 to 29 kg/m2, while the risk increased for lower and higher BMIs. Such non-linear patterns suggest that the health effects of BMI may not always be directly mediated by adipose content or body weight and other factors might also need to be optimized in addition to BMI to improve outcomes after TKA.” – by Casey Tingle

Disclosures: Khlopas reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.