Background: The rates of obesity among patients undergoing total knee arthroplasty (TKA) have substantially increased. In addition, obesity is a well-established risk factor for complications after TKA. The purpose of this study was to analyze trends in body mass index (BMI) and complication risk among obese patients undergoing primary TKA treated at a single institution over 3 decades.
Methods: Utilizing an institutional total joint registry, 13,919 primary TKAs performed to treat osteoarthritis between 1990 and 2019 were identified. Patients were stratified by BMI according to the World Health Organization (WHO) classification into 3 groups: non-obese (BMI, <30 kg/m 2 ), WHO Class-I and II obese (BMI, 30 to 39.9 kg/m 2 ), and WHO Class-III obese (BMI, ≥40 kg/m 2 ). Trends in BMI and survivorship free from reoperation, revision, and periprosthetic joint infection (PJI) were analyzed over time while controlling for age, sex, and the Charlson Comorbidity Index.
Results: Over the study period, there was a 90% increase in the prevalence of Class-II obesity (13% to 25%) and a 300% increase in Class-III obesity (3% to 12%). Analysis of the entire cohort demonstrated a decrease in the 2-year risk of any reoperation, any revision, and PJI (p < 0.05 for all) with time. The risk decreased significantly over time for non-obese patients for any reoperation (p = 0.029) and any revision (p = 0.004) and for Class-III obese patients for any reoperation (p = 0.038) and any revision (p = 0.012), but it remained stable for Class-I and II obese patients. The risk of PJI decreased from 1990 to 2019 for non-obese patients (p = 0.005), but there were no significant changes in PJI risk for any obesity group.
Conclusions: Despite increasing rates of obesity among our patients who underwent TKA, we observed decreasing risks of reoperation, revision, and PJI over time. The risks of reoperation and revision declined among non-obese patients, remained stable for Class-I and II obese patients, and declined for Class-III obese patients. The PJI risk declined for non-obese patients over the study period, but no such decline occurred for any category of obesity. Despite the decreasing risks of reoperation and revision, further work is needed to improve PJI risk in obese patients.
Level Of Evidence: Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.2106/JBJS.23.01413 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Individualized symptom experience and predictors in cancer patients after oesophagectomy: A latent profile analysis.
Eur J Oncol Nurs
January 2025
School of Nursing, Anhui Medical University, China. Electronic address:
Purpose: In the care for oesophageal cancer, symptom assessment was mainly carried out from the perspective of the total score using scales, which ignored individual differences in symptom experience among patients. To provide personalized symptom management, individual differences among patients with oesophageal cancer warranted further investigation. The objective was to identify the different symptom profiles of patients after oesophagectomy and examine the risk factors affecting the symptom profiles.
View Article and Find Full Text PDFThree cases of hemoglobin M disease in a family lineage: Case report and literature review.
Medicine (Baltimore)
January 2025
Department of Pediatric Hematology, Children's Medical Center, The First Hospital of Jilin University, Changchun, China.
Rationale: This study presents a case of hemoglobin M disease (HMD), a rare inherited disorder characterized by persistent cyanosis and hypoxemia, observed across 3 generations within a single family. The diagnosis of HMD poses significant challenges, particularly in asymptomatic individuals, due to its rarity and the subtlety of its symptoms. Notably, there is a scarcity of reports on methemoglobinemia in pediatric populations, which further complicates early detection and intervention.
View Article and Find Full Text PDFImaging characteristics and treatment of recurrent germinoma.
J Neurosurg
January 2025
1Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima; and.
Objective: An MRI protocol for germinoma surveillance after complete remission has not been established. Moreover, the standard treatment for recurrent or refractory germinoma has not been determined. In this study, the authors explored the imaging characteristics of recurrent germinoma and discuss their institution's experience with multidisciplinary treatment of this malignancy.
View Article and Find Full Text PDFStandardizing postoperative pain control for decompression of pediatric Chiari type I malformation by limiting narcotic usage.
J Neurosurg Pediatr
January 2025
2Division of Pediatric Neurosurgery, Johns Hopkins All Children's Hospital, St. Petersburg, Florida.
Objective: The aim of this study was to assess the effectiveness of a postoperative multimodal pain control protocol on perioperative pain scores in children undergoing decompression for Chiari type I malformation (CM-I).
Methods: This retrospective matched cohort study included patients < 21 years of age who underwent elective suboccipital craniectomy and C1 laminectomy for CM-I with or without duraplasty at a single center from January 2020 to July 2023. A standardized, multimodal postoperative pain protocol was implemented in August 2021 that did not use narcotic patient-controlled analgesia.
Preoperative Anemia as a Prognostic Risk Factor for Inferior Oncological Survival Following Resection for Pancreatic Ductal Adenocarcinoma.
Pancreas
January 2025
Department of Surgery, Division of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University Medical Center Groningen, University of Groningen, the Netherlands.
Objectives: A significant proportion of patients undergoing surgery for pancreatic ductal adenocarcinoma (PDAC) are anemic at the time of resection. In these patients, blood transfusions are omitted due to their potential negative impact on oncological outcomes. The aim of the present study was to determine the prognostic value of preoperative anemia in resected PDAC patients, irrespective of blood transfusion status.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!