Arthroplasty today · 2026
The Impact of Preoperative Weight Loss on 90-Day Complications Following Primary Total Knee Arthroplasty.
СтатьяНазвание и аннотация: Перевод в очереди
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Lewis John Paul, Ziemba-Davis Mary, Buller Leonard T, Sonn Kevin A
Аннотация
BACKGROUND: Access to primary total knee arthroplasty (TKA) for morbidly obese (MO) patients is often restricted to reduce complications. We compared complication rates in patients who were MO or non-MO (NMO) at initial presentation based on whether their body mass index (BMI) had decreased by ≥5%, remained stable, or increased by ≥5% at the time of surgery, hypothesizing that preoperative weight loss does not reduce complication rates.
METHODS: Prospectively collected data for 2219 unilateral, primary TKAs were retrospectively reviewed. Cases were performed between 2012 and 2023 at the same academic center by 4 fellowship-trained surgeons using standardized protocols. Twenty-eight percent (n = 627) were MO and 72% (n = 1592) were NMO at initial presentation. Outcomes included intraoperative and 90-day complications and reoperations. Outcome covariates included patient demographics and comorbidities, as well as operative details. Independent samples t-tests and chi-squared tests were used for statistical analysis.
RESULTS: Intraoperative complications (P = .999), medical complications (P ≥ .398), death (P = .299), superficial or deep infection (P = .731), and reoperation on the index joint within 90 days of surgery (P = .801) did not differ in MO patients with a ≥5% decrease vs stable BMI before surgery. These outcomes also did not differ between NMO patients with a ≥5% decrease in BMI and those with stable BMI before surgery (P ≥ .250).
CONCLUSIONS: Findings suggest that withholding surgery from patients who are clinically indicated for TKA pending weight loss may not be necessary to reduce early postoperative complications.
METHODS: Prospectively collected data for 2219 unilateral, primary TKAs were retrospectively reviewed. Cases were performed between 2012 and 2023 at the same academic center by 4 fellowship-trained surgeons using standardized protocols. Twenty-eight percent (n = 627) were MO and 72% (n = 1592) were NMO at initial presentation. Outcomes included intraoperative and 90-day complications and reoperations. Outcome covariates included patient demographics and comorbidities, as well as operative details. Independent samples t-tests and chi-squared tests were used for statistical analysis.
RESULTS: Intraoperative complications (P = .999), medical complications (P ≥ .398), death (P = .299), superficial or deep infection (P = .731), and reoperation on the index joint within 90 days of surgery (P = .801) did not differ in MO patients with a ≥5% decrease vs stable BMI before surgery. These outcomes also did not differ between NMO patients with a ≥5% decrease in BMI and those with stable BMI before surgery (P ≥ .250).
CONCLUSIONS: Findings suggest that withholding surgery from patients who are clinically indicated for TKA pending weight loss may not be necessary to reduce early postoperative complications.