2021 ISAKOS Biennial Congress ePoster
Highest Body Mass Index is Seen in Younger Patients Undergoing Total Knee Arthroplasty with Increased Length of Stay and Risk of Complications
Jonathan R Manara, BMBS, FRCS (Tr & Orth), Newport, U.K. UNITED KINGDOM
Ben Doughty, MBChB, Bsc, Bristol UNITED KINGDOM
Alex Curtis, MBChB, BSc (Hons), MRCS, PGCert, Bristol UNITED KINGDOM
Hugo Beaumont, BMBS, BSc (Hons), Bristol UNITED KINGDOM
Justin Leathes, MBChB, BSc (Hons), Bristol UNITED KINGDOM
Sven Edward Putnis, MB ChB FRCS(Tr&Orth), Bristol, Somerset UNITED KINGDOM
Avon Orthopaedic Centre, Bristol, Gloucestershire, UNITED KINGDOM
FDA Status Cleared
Summary
The youngest patients presenting for TKA are also seen with the highest BMI, and despite their age they have longer inpatient requirements and higher complication rates
ePosters will be available shortly before Congress
Abstract
Introduction
Obesity is a major risk factor for knee osteoarthritis, seen seven times more frequently when compared to people with a body mass index (BMI) less than 25. Complications in total knee arthroplasty (TKA) are also significantly higher with a 3.7 times greater risk of periprosthetic joint infection in all TKA in those with a BMI over 40. This study aimed to evaluate the peri-operative outcomes of patients within different BMI ranges undergoing TKA in a single centre.
Methods
All patients undergoing TKA between January 2019 and March 2020 were included in a retrospective review using UK National Joint Registry data and hospital records recording demographics, lengths of stay (LOS), complication rates (clavien-dindo definition), and readmissions within 60 days.
Results
The full cohort included 528 TKA. Comparison of the group of 87 (17%) with a BMI >40 (mean 43 ± 3.2 [40 – 52.5]) to those with BMI <40 showed they were both significantly younger (mean age 64.6 versus 70.2, p < 0.001), and with a higher mean ASA (2.7 versus 2.4, p < 0.001). In the BMI >40 group a significantly higher LOS was seen (mean 5.49 vs 4.42 days, p = 0.004), and they were more likely to stay >7 days (11% vs 5% p = 0.04). Significantly higher rates of reoperation (8% vs 2%, p = 0.012), including four re-operations for infection in the high BMI group and two in the lower BMI group were seen. Readmissions within 60 days were not significantly different between groups (9.8% vs 10.3% p=0.85).
Discussion
There is a large proportion of patients suitable for TKA with high BMI, and this was seen in younger patients with more co-morbidities. The risk of a prolonged LOS and higher reoperation rate is seen in this group. The results suggest an urgent need for further research in the management and optimisation of patients with obesity and knee osteoarthritis.