Matthieu Zingg1, Hermès H Miozzari2, Daniel Fritschy2, Pierre Hoffmeyer2, Anne Lübbeke2. 1. Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, 1211, Genève 14, Switzerland. matthieu.zingg@hcuge.ch. 2. Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, 1211, Genève 14, Switzerland.
Abstract
PURPOSE: Studies demonstrate that revision rates after primary total knee arthroplasty (TKA) tend to be higher in obese patients. However, the existence of a body mass index (BMI) threshold remains unexplored. METHODS: We conducted a prospective cohort study of 2442 primary TKAs in 2035 patients (69.1 % women; mean age 72 years; mean follow-up 93 months, range 38-203). We evaluated the influence of BMI in five categories on all-cause revision after TKA using incidence rates (IR), hazard ratios (HR), and Kaplan-Meier survival analysis. Adjustment for baseline imbalances was performed using Cox regression analysis. RESULTS: Over the study period, 71 revisions occurred. Revision rates were 3.2 cases/1000 patient-years for patients of normal weight, 3.4/1000 for overweight patients and 3.0/1000 for patients classified as obese class I. At BMI ≥ 35, a significant increase in revision was noted. Comparing BMI ≥ 35 vs. < 35, there were 6.4 vs. 3.2 /1000. Crude HR was 2.0 [95 % confidence interval (CI) 1.2-3.3, p = 0.009], and the adjusted HR was 2.1 (95 % CI 1.2-3.6, p = 0.008). CONCLUSION: All-cause revision rates after primary TKA doubled in patients with a BMI of 35 but were similar in those with a BMI <35.
PURPOSE: Studies demonstrate that revision rates after primary total knee arthroplasty (TKA) tend to be higher in obesepatients. However, the existence of a body mass index (BMI) threshold remains unexplored. METHODS: We conducted a prospective cohort study of 2442 primary TKAs in 2035 patients (69.1 % women; mean age 72 years; mean follow-up 93 months, range 38-203). We evaluated the influence of BMI in five categories on all-cause revision after TKA using incidence rates (IR), hazard ratios (HR), and Kaplan-Meier survival analysis. Adjustment for baseline imbalances was performed using Cox regression analysis. RESULTS: Over the study period, 71 revisions occurred. Revision rates were 3.2 cases/1000 patient-years for patients of normal weight, 3.4/1000 for overweight patients and 3.0/1000 for patients classified as obese class I. At BMI ≥ 35, a significant increase in revision was noted. Comparing BMI ≥ 35 vs. < 35, there were 6.4 vs. 3.2 /1000. Crude HR was 2.0 [95 % confidence interval (CI) 1.2-3.3, p = 0.009], and the adjusted HR was 2.1 (95 % CI 1.2-3.6, p = 0.008). CONCLUSION: All-cause revision rates after primary TKA doubled in patients with a BMI of 35 but were similar in those with a BMI <35.
Entities:
Keywords:
Body mass index (BMI); Obesity; Revision; Threshold; Total knee arthroplasty (TKA)
Authors: Qais Naziri; Kimona Issa; Arthur L Malkani; Peter M Bonutti; Steven F Harwin; Michael A Mont Journal: Clin Orthop Relat Res Date: 2013-07-10 Impact factor: 4.176
Authors: Aaron M Wendelboe; Kurt T Hegmann; Jeremy J Biggs; Chad M Cox; Aaron J Portmann; Jacob H Gildea; Lisa H Gren; Joseph L Lyon Journal: Am J Prev Med Date: 2003-11 Impact factor: 5.043
Authors: Nicholas J Giori; Derek F Amanatullah; Shalini Gupta; Thomas Bowe; Alex H S Harris Journal: J Bone Joint Surg Am Date: 2018-04-04 Impact factor: 5.284
Authors: David Gøttsche; Kirill Gromov; Petra H Viborg; Elvira V Bräuner; Alma B Pedersen; Anders Troelsen Journal: Acta Orthop Date: 2018-12-05 Impact factor: 3.717