Volume : 2, Issue : 4, April - 2013

Is Overweight Or Obesity a Perioperative Risk Factor in Total Knee Arthroplasty?

Alexander Bican, A. Sailaja, Wolfgang Honle , Alexander Schuh

Abstract :

There is only little information given about perioperative morbidity and TKR in obese patients. Aim of this study was to investigate the influence of BMI on perioperative complications following total knee replacement (TKR) in a single surgeon. Material and method: This study was based on the retrospective review of charts from 201 patients who had undergone TKR between April 2007 and December 2009 at our hospital. We reviewed all BMIs and divided the patients into 2 groups: BMI < 30 (I) and BMI > 30 (II) (Obesity). Data were then analysed for frequencies, Mann– Whitney U–Test, Wilcoxon – Test and Chi–squared test. All patients were followed up by one of us (BA) 6 weeks after operation. Results: Local minor complications included superficial hematoma requiring no revision in 15/99 cases (I) and 17/102 cases (II) (p = 0.46). There were 4 effusions in group I and 4 in group II requiring puncture (p = 0.623). Dehiscence of the wound requiring no revision was found in 0/99 cases (I) and 4/102 cases (II) ( p= 0.064). Further minor complications included superficial infection requiring no revision in 3/99 cases (I) and 9/102 cases (II) (p = 0.074). Local major complications included deep infection requiring revision in 0/99 cases (I) and 6/102 cases (II) (p = 0.016). General major complications included deep vein thrombosis in 1/99 cases (I) and 2/102 cases (II) (p = 0.511), pneumonia in1/99 case (I) and 1/102 cases (II) (p = 0.744). Discussion: We were able to show that obesity leads to a higher risk of infection in TKR. Despite this fact obese patients should not be excluded from TKR nowadays. Nevertheless patients should still be encouraged to reduce their weight prior to surgery and should be informed about the higher risk of infections in TKA preoperatively.