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Should isolated morbid obesity influence the decision to operate in hip and knee arthroplasty?

Authors :
Peter F. Crookes
Roslyn S. Cassidy
Aleksander Machowicz
Janet C. Hill
John McCaffrey
Gillian Turner
David Beverland
Source :
Bone & Joint Open, Vol 2, Iss 7, Pp 515-521 (2021)
Publication Year :
2021
Publisher :
The British Editorial Society of Bone & Joint Surgery, 2021.

Abstract

Aims: We studied the outcomes of hip and knee arthroplasties in a high-volume arthroplasty centre to determine if patients with morbid obesity (BMI ≥ 40 kg/m2) had unacceptably worse outcomes as compared to those with BMI < 40 kg/m2. Methods: In a two-year period, 4,711 patients had either total hip arthroplasty (THA; n = 2,370), total knee arthroplasty (TKA; n = 2,109), or unicompartmental knee arthroplasty (UKA; n = 232). Of these patients, 392 (8.3%) had morbid obesity. We compared duration of operation, anaesthetic time, length of stay (LOS), LOS > three days, out of hours attendance, emergency department attendance, readmission to hospital, return to theatre, and venous thromboembolism up to 90 days. Readmission for wound infection was recorded to one year. Oxford scores were recorded preoperatively and at one year postoperatively. Results: On average, the morbidly obese had longer operating times (63 vs 58 minutes), longer anaesthetic times (31 vs 28 minutes), increased LOS (3.7 vs 3.5 days), and significantly more readmissions for wound infection (1.0% vs 0.3%). There were no statistically significant differences in either suspected or confirmed venous thromboembolism. Improvement in Oxford scores were equivalent. Conclusion: Although morbidly obese patients had less favourable outcomes, we do not feel that the magnitude of difference is clinically significant when applied to an individual, particularly when improvement in Oxford scores were unrelated to BMI.

Details

Language :
English
ISSN :
26331462
Volume :
2
Issue :
7
Database :
Directory of Open Access Journals
Journal :
Bone & Joint Open
Publication Type :
Academic Journal
Accession number :
edsdoj.68de8a4e0a4d9ca289bb1c1adb0751
Document Type :
article
Full Text :
https://doi.org/10.1302/2633-1462.27.BJO-2021-0062.R1