Morbid Obesity in Revision Total Knee Arthroplasty: A Significant Risk Factor for Re-Operation

被引：18

作者：

Sisko, Zachary W. ^{[1
,2
]}

Vasarhelyi, Edward M. ^{[1
]}

Somerville, Lyndsay E. ^{[1
]}

Naudie, Douglas D. ^{[1
]}

MacDonald, Steven J. ^{[1
]}

McCalden, Richard W. ^{[1
]}

机构：

[1] Western Univ, Schulich Sch Med & Dent, London Hlth Sci Ctr, Div Orthopaed Surg,Dept Surg, London, ON, Canada

[2] Allegheny Hlth Network, Pittsburgh Bone Joint & Spine Inc, 1200 Brooks Lane,Suite G-20, Jefferson Hills, PA 15025 USA

来源：

JOURNAL OF ARTHROPLASTY | 2019年 / 34卷 / 05期

关键词：

revision knee arthroplasty; morbid obesity; complications; risk factors; infection; aseptic loosening; BODY-MASS INDEX; TOTAL HIP; INFECTION; OVERWEIGHT; OUTCOMES; FAILURE; WEIGHT;

D O I：

10.1016/j.arth.2019.01.010

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Background: The purpose of this study is to compare surgical and clinical outcomes between matched groups of morbidly obese (body mass index [BMI] > 40 kg/m(2)) and non-morbidly obese (BMI < 40 kg/m(2)) patients undergoing first-time revision total knee arthroplasty with a minimum 5-year follow-up. Methods: Two groups of 87 patients (BMI > 40 or < 40 kg/m(2)) were matched 1: 1 based on age at the time of revision, gender, and diagnosis for revision (aseptic or septic causes). Results: The morbidly obese group had a significantly greater incidence of re-operation (34.5% [30/87] vs 16.1% [14/87], P =.005) and re-revision (27.6% [24/87] vs 12.6% [11/87], P =.014) with a significantly lower 10-year survivorship for re-operation (P =.05) and subsequent revision (P =.014). In particular, the aseptic sub-group had a greater incidence of re-operation (29.9% [20/67] vs 13.4% [9/67], P =.021) and rerevision (26.9% [18/67] vs 11.9% [8/67], P =.029). The non-morbidly obese group demonstrated higher final Western Ontario and McMaster Universities Index scores (63.1 +/- 19.5 vs 55.5 +/- 22.5, P =.030) and a greater change between pre-operative and final KSS (45.6 +/- 44.3 vs 39.7 +/- 48.4, P =.040) and SF-12 Mental component (3.6 +/- 10.8 vs -1.4 +/- 10.3, P =.013). Conclusion: Morbidly obese patients undergoing revision total knee arthroplasty have a greater risk of re-operation and re-revision while experiencing lower clinical outcome scores compared to nonmorbidly obese patients. These patients should be informed of the higher potential for re-operation and the possibility of poor results. (c) 2019 Elsevier Inc. All rights reserved.

引用

页码：932 / 938

页数：7