Functional Outcomes After Total Knee Arthroplasty In Obese Patients

Objective:To assess the clinical outcomes and complications of primary total knee arthroplasty(TKA)in normal weight patients,overweight patients and obese patients.Methods:A total of 152 obese patients who had undergone a primary TKA were stratified by BMI(≤23.9kg/m2, normal group, n=52; 24.0-27.9kg/m2, overweight group, n=50 and ≥28kg/m2,obese group, n=50).Preoperative demographics,perioperative and postoperative complications were recorded. They were followed up for two years and the outcomes were assessed using the american knee society knee score(KSS), short form-36(SF-36), visual analog scale pain scores(VAS) and the length of hospital stay.Results:The american knee society knee score(KSS), short form-36(SF-36) and visual analog scale pain score(VAS)were significantly ameliorated in all groups(P<0.05). Moreover, there was no difference in the length of hospital stay among the three groups.The obese patients had a higher rate of complications than normal weight patients and overweight patients(P<0.001).In the normal group,there were one deep-vein thrombosis.There were one superficial wound infection in the overweight group that required negative pressure wound therapy.In the obese group,there were one superficial wound infection that required negative pressure wound therapy and one deep infection that required surgical irrigation and debridement.One patients developed symptoms consistent with peroneal nerve palsy.Conclusions:Total knee arthroplasty in overweight and obese patients can be successful at short term follow-up,but the potential perioperative complications in obese patients requires close attention.