Summary

Primary total knee arthroplasty surgery in overweight and obese patients as the only measure to lose weight is insufficient, since it is not related to a significant increase in physical activity, even more so when this is one of the multiple factors involved in a plan to lose weight.

Abstract

Introduction. The increase in BMI of the world population is associated with a higher prevalence of knee osteoarthritis, therefore, a greater amount of total knee arthroplasty (TKA). It is considered good practice to encourage overweight and obese patients to lose weight before surgery, to reduce complications and improve functional results. However, patients frequently report inability to lose weight as severe knee pain limits the ability to perform calorie-spending exercises.
Objective. To establish how primary TKA affects weight loss in overweight and obese patients. In turn, it is also proposed to determine the impact on physical activity in these patients undergoing primary TKA.
Materials and methods. A retrospective follow-up of 49 overweight and obese patients undergoing primary TKA was carried out at the Hospital Italiano de Córdoba by the Orthopedics and Traumatology service between June 2016 and June 2019. The pre-surgical and post-surgical BMI were taken into account the first time. and second year of control and the activity of each patient using the LEAS scale.
Results. Physical activity evaluated with the LEAS score had an increase of 1.4 points on average in overweight patients at 2 years. In obese patients it had an increase of 1.7 at 2 years. 12 patients had a significant decrease in weight (24.5%), another 12 gained weight (24.5) and 25 (51%) did not present significant changes in weight with respect to preoperative weight.
Discussion. The pre-surgical LEAS score was compared, one year and two years after surgery. There is a slight increase in physical activity in patients undergoing TKA, although it is not correlated with a decrease in BMI at 2 years.
Conclusion. Primary total knee arthroplasty surgery in overweight and obese patients as the only measure to lose weight is insufficient, since it is not related to a significant increase in physical activity, even more so when this is one of the multiple factors involved in a plan to lose weight.