Higher body mass index is not a risk factor for in-hospital adverse outcomes following total knee arthroplasty. (1st October 2018)

• Record Type: Journal Article
• Authors: Gurunathan, Usha; Pym, Aaron; Anderson, Cameron; Marshall, Amanda; Whitehouse, Sarah L; Crawford, Ross W
• Is Part Of: Journal of orthopaedic surgery. Volume 26:Number 3(2018)
• Publication Date: 2018-10-01
• Subjects: adverse outcomes -- BMI -- obesity -- postoperative -- total knee arthroplasty; Orthopedic surgery -- Periodicals; Orthopedics; Orthopedic surgery; Periodicals; 617.3
• DOI: 10.1177/2309499018802429
• Languages: English
• ISSNs: 1022-5536

Abstract

Purpose: To investigate the association between body mass index (BMI) and perioperative complications until hospital discharge, following primary total knee arthroplasty (TKA). Methods: This retrospective study reviewed 1665 cases of elective primary unilateral TKA performed between 2006 and 2010, from a prospective secure electronic database. Types of complications, length of operating time, and duration of hospital stay were analyzed in both adjusted (for known confounders) and unadjusted analyses. A further matched analysis was also performed. Results: In terms of overall complications, there was no statistically significant difference between the BMI categories. When individual obesity category was considered, obese 2 had the lowest odds of developing complications, both with unadjusted (odds ratio (OR): 0.61, 95% confidence interval (CI) 0.41–0.91, p < 0.015) and adjusted regression analysis (OR: 0.65, 95% CI: 0.43–0.99, p = 0.044). Compared to normal weight category, obese class 3 (≥40 kg/m 2 ) individuals were at 66% (OR: 0.34, 95% CI: 0.21–0.55) lower (unadjusted) odds of developing cardiac complications (overall p < 0.001). With the matched analysis, compared to normal weight category, obese class 3 (≥40 kg/m 2 ) individuals were at a 60% (OR: 0.40, 95% CI: 0.23–0.68) lower (unadjusted) odds of developing cardiac complications (overall p = 0.004). Obese 3 patients had significantly higher operating time compared with other groups ( p < 0.001). Conclusion: This study did not find a significant association between BMI and increased overall in-hospital medical or surgical complications following primary TKA. Obesity significantly increased the length of operating time.