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 Adult Knee Reconstruction Test 6: Topics in Total Knee Arthroplasty
CME 3: July, August, September 2004
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The Journal of Bone and Joint Surgery (American) 86:1609-1615 (2004)
© 2004 The Journal of Bone and Joint Surgery, Inc.

The Outcome of Total Knee Arthroplasty in Obese Patients

Jared R.H. Foran, BA1, Michael A. Mont, MD2, Gracia Etienne, MD, PhD2, Lynne C. Jones, PhD1 and David S. Hungerford, MD1

1 Department of Orthopaedic Surgery, The Good Samaritan Hospital, Arthritis Division of Johns Hopkins University School of Medicine, 5601 Loch Raven Boulevard, Baltimore, MD 21115
2 Rubin Institute for Advanced Orthopaedics, Center for Joint Preservation and Reconstruction, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD 21215. E-mail address for M.A. Mont: rhondamont{at}aol.com

Investigation performed at The Good Samaritan Hospital, Baltimore, Maryland

In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from Stryker-Howmedica-Osteonics, Allendale, New Jersey. None of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. A commercial entity (Stryker-Howmedica-Osteonics) paid or directed, or agreed to pay or direct, benefits to a research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

A video supplement to this article is available from the Video Journal of Orthopaedics. A video clip is available at the JBJS web site, www.jbjs.org. The Video Journal of Orthopaedics can be contacted at (805) 962-3410, web site: www.vjortho.com.

Background: Evidence linking increased body weight to osteoarthritis of the knee and the high prevalence of obesity underscore the importance of defining the outcome of total knee arthroplasty in obese patients. The purpose of this study was to compare the clinical and radiographic results of total knee arthroplasties performed in obese patients with those of total knee arthroplasties performed in nonobese patients.

Methods: Clinical and radiographic data on seventy-eight total knee arthroplasties in sixty-eight obese patients were compared with data on a matched group of nonobese patients. The analysis was also performed after stratification of the obese group for the degree of obesity. All patients had the same prosthesis. The clinical data that were analyzed included the Knee Society objective and functional scores, patellofemoral symptoms, activity level, and complications.

Results: The percentage of knees with a Knee Society score of ≥80 points at an average of eighty months was 88% in the obese group, which was significantly lower than the 99% rate in the nonobese group at the same time. The morbidly obese subgroup had a significantly higher revision rate than did the nonobese group (p = 0.02).

Conclusions: The results of the present study suggest that any degree of obesity, defined as a body mass index of ≥30, has a negative effect on the outcome of total knee replacement.

Level of Evidence: Prognostic study, Level II-1 (retrospective study). See Instructions to Authors for a complete description of levels of evidence.


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