Features of total knee arthroplasty for obese patients

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Abstract

OBJECTIVE:

To investigate the technical tips and outcomes of total knee arthroplasty in obese patients and compare them with non-obese patients.

METHODS:

A total of 80 patients (80 knees) with knee osteoarthritis, who underwent unilateral total knee arthroplasty for the first time using posterior stable-fixed plateau prosthesis in Department of Orthopaedics, Peking Union Medical College Hospital between September 2004 and March 2007, were selected. Of them, people with body mass index < 25.0 kg/m2 were regarded as non-obese group (n=40), and body mass index ≥ 27.1 kg/m2 were regarded as obese group (n=40). All patients were followed up regularly. The maximum extension/flexion degree of knee joint and HSS score at preoperative and latest follow-up as well as perioperative complications were recorded.

RESULTS:

All patients were followed up for 36.7 months (ranging 25-54 months). The maximum flexion degrees and HSS scores of both groups were significantly greater than before surgery (P < 0.05), while the maximum extension degrees was less than before surgery (P < 0.05). The maximum extension/flexion degrees and HSS scores of obese groups before surgery and at the latest follow-up were similar to non-obese group (P > 0.05). In the non-obese group, 1 case developed wound complication, with incidence of 2.5%; in obese group, 4 cases had wound problems, including 1 combined with deep venous thrombosis and 2 combined with joint stiffness, with incidence of 10%. There were significant differences between two groups in incidence of complications (P < 0.05).

CONCLUSION:

Total knee arthroplasty is an effective therapy for advanced knee osteoarthritis. Obese patient could obtain similar outcome to non-obese after total knee arthroplasty, but its perioperative complication such as wound and deep venous thrombosis requires close attention.

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