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J Arthroplasty. 2016 Nov;31(11):2408-2414. doi: 10.1016/j.arth.2016.04.028. Epub 2016 Apr 30.

Total Knee Arthroplasty in Obesity: In-Hospital Outcomes and National Trends.

Author information

1
Department of Orthopaedic Surgery, University of Illinois at Chicago, Chicago, Illinois.
2
Department of Orthopaedic Surgery, University of Illinois at Chicago, Chicago, Illinois; Illinois Bone and Joint Institute, Morton Grove, Illinois.

Abstract

BACKGROUND:

Both the prevalence of obesity and the utilization rate of total knee arthroplasty are increasing. The rate and proportion of total knee arthroplasty (TKA) performed in the setting of obesity/morbid obesity is increasing significantly over time.

METHODS:

Using International Classification of Diseases-Ninth Revision codes, we searched the National Hospitals Discharge Survey national database for patients admitted for primary TKA between 2001 and 2010. We then used International Classification of Diseases-Ninth Revision codes for obesity (body mass index = 30-40 kg/m2) and morbid obesity (body mass index, ≥ 40 kg/m2) to select the obese cohorts.

RESULTS:

We found 29,694 nonobese, 2645 obese, and 1150 morbidly obese patients. There was an increase in each group over time. The rate of obesity/morbid obesity was strongly correlated with time. Obese and morbidly obese patients were more likely to be younger, female, diabetic, and have Medicaid than nonobese patients. Obese and morbidly obese patients had shorter hospital stays and higher home discharge rates than nonobese patients. Obese and morbidly obese patients had lower transfusion rates, shorter hospital stays, and no increase in inpatient wound infection or venous thromboembolic complications than nonobese patients. The Midwest region saw a greater burden of obese TKA patients.

CONCLUSION:

With the right measures and precautions, satisfactory inhospital outcomes are possible in the obese patient after primary TKA. A limitation of this study is short inhospital stay of the index procedure as complications may present later after discharge.

KEYWORDS:

complications; database; obesity; osteoarthritis; total knee arthroplasty

PMID:
27259393
DOI:
10.1016/j.arth.2016.04.028
[Indexed for MEDLINE]

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