Arthroplasty (London, England) · 2026
Does weight gain from time of indication to date of surgery affect outcomes in total knee arthroplasty?
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Sarfraz Anzar, Di Pauli von Treuheim Theodor, Ruff Garrett, Saba Braden V, Khury Farouk, Schwarzkopf Ran, Rozell Joshua C, Aggarwal Vinay K
Аннотация
BACKGROUND: The impact of body mass index (BMI) on outcomes after total knee arthroplasty (TKA) is a highly debated topic. Our study aims to investigate the implications of BMI changes from the day of surgical booking to the surgery date on perioperative and postoperative outcomes.
METHODS: We retrospectively reviewed patients who underwent elective, primary, unilateral TKA at an urban academic institution from 2015-2024 with a minimum 90-day follow-up. The cohort was classified into three groups by percent BMI change from surgical booking date to TKA date: Group 1, decrease in BMI; Group 2, 0-5% increase in BMI; and Group 3, > 5% increase in BMI. Propensity-score matching (1:1:1) based on age, gender, BMI at surgical booking, and smoking status was performed; perioperative and postoperative outcomes were compared. Multivariate regression analysis evaluated risk factors for interval change in BMI.
RESULTS: Before matching, 12,990 patients were included, with 39.6% in Group 1, 41.2% in Group 2, and the remaining 19.2% in Group 3. Notably, Group 3 had the longest length of stay (50.3 h vs. 48.6 [1] & 47.1 [2]; P = 0.002) and the lowest discharge-to-home rates (88.7% vs. 89.8% [1] & 91.7% [2]; P = 0.014). No significant difference was seen in 90-day ED visits, 90-day readmissions, or revision rates. Logistic regression of the pre-match cohort found that prolonged surgical booking delays were associated with decreased all-cause revisions (OR = 0.98; P = 0.038), while percent BMI change in this period did not impact revision incidence. Duration of surgical booking delay had no impact on BMI changes in obese patients.
CONCLUSION: Our study evaluated preoperative BMI change between surgical booking and TKA, finding that most patients (60.4%) gain weight during this time. While patients with significant BMI increases (> 5%) had longer hospital stays and lower discharge-to-home rates, Percent BMI change during this period did not impact all-cause or septic revision incidence.
METHODS: We retrospectively reviewed patients who underwent elective, primary, unilateral TKA at an urban academic institution from 2015-2024 with a minimum 90-day follow-up. The cohort was classified into three groups by percent BMI change from surgical booking date to TKA date: Group 1, decrease in BMI; Group 2, 0-5% increase in BMI; and Group 3, > 5% increase in BMI. Propensity-score matching (1:1:1) based on age, gender, BMI at surgical booking, and smoking status was performed; perioperative and postoperative outcomes were compared. Multivariate regression analysis evaluated risk factors for interval change in BMI.
RESULTS: Before matching, 12,990 patients were included, with 39.6% in Group 1, 41.2% in Group 2, and the remaining 19.2% in Group 3. Notably, Group 3 had the longest length of stay (50.3 h vs. 48.6 [1] & 47.1 [2]; P = 0.002) and the lowest discharge-to-home rates (88.7% vs. 89.8% [1] & 91.7% [2]; P = 0.014). No significant difference was seen in 90-day ED visits, 90-day readmissions, or revision rates. Logistic regression of the pre-match cohort found that prolonged surgical booking delays were associated with decreased all-cause revisions (OR = 0.98; P = 0.038), while percent BMI change in this period did not impact revision incidence. Duration of surgical booking delay had no impact on BMI changes in obese patients.
CONCLUSION: Our study evaluated preoperative BMI change between surgical booking and TKA, finding that most patients (60.4%) gain weight during this time. While patients with significant BMI increases (> 5%) had longer hospital stays and lower discharge-to-home rates, Percent BMI change during this period did not impact all-cause or septic revision incidence.