Kavin Sundaram1, Jared Warren2, Hiba Anis3, Jaiben George4, Trevor Murray5, Carlos A Higuera6, Nicolas S Piuzzi7. 1. Department of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Ave/A41, Cleveland, OH 44195, United States of America. Electronic address: sundark2@ccf.org. 2. Department of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Ave/A41, Cleveland, OH 44195, United States of America. Electronic address: warrenj4@ccf.org. 3. Department of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Ave/A41, Cleveland, OH 44195, United States of America. Electronic address: anish@ccf.org. 4. All-Indian Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. 5. Department of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Ave/A41, Cleveland, OH 44195, United States of America. Electronic address: murrayt2@ccf.org. 6. Department of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Ave/A41, Cleveland, OH 44195, United States of America. Electronic address: higuerac@ccf.org. 7. Department of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Ave/A41, Cleveland, OH 44195, United States of America; Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. Electronic address: piuzzin@ccf.org.
Abstract
BACKGROUND: The association of postoperative complications and obesity after total knee arthroplasty (TKA) has been well described. However, the effect of an increased body-mass index (BMI) on postoperative complications after unicompartmental knee arthroplasty (UKA) is controversial. Therefore, our aim was to assess the influence of BMI on 30-day postoperative complications after UKA when analyzed as both a categorical and continuous variable. METHODS: The American College of Surgeons National Quality Improvement Program (NSQIP) database was used to identify a total of 8029 patients who underwent UKA from January 1, 2008, to December 31, 2016. The database was queried for over 30 unique complications occurring within 30 days. The impact of BMI on short-term outcomes was assessed as a categorical variable using univariate and multivariate regression. Additionally, BMI was assessed as a continuous variable using spline regressions. RESULTS: Univariate regression analysis revealed that compared to normal weight patients, overweight patients had a lower risk of major complication (odds ratio [OR], 0.506; 95% confidence interval [CI], 0.279-0.918; p = 0.025), and any complication ([OR] 0.632; 95% CI, 0.423-0.944; p = 0.025) Multivariate regression analysis found no statistically significant relationship between categorical BMI and complications or outcomes, except for morbidly obese patients who had a greater risk of superficial SSI (p = 0.026). Spline regression found no statistically significant non-linear relationships between BMI and any complication (p = 0.4687), major complications (p = 0.1567), or minor complications (p = 0.4071). CONCLUSION: Overweight and obese individuals who undergo UKA may not have an increased risk of 30-day postoperative complications compared to normal weight individuals.
BACKGROUND: The association of postoperative complications and obesity after total knee arthroplasty (TKA) has been well described. However, the effect of an increased body-mass index (BMI) on postoperative complications after unicompartmental knee arthroplasty (UKA) is controversial. Therefore, our aim was to assess the influence of BMI on 30-day postoperative complications after UKA when analyzed as both a categorical and continuous variable. METHODS: The American College of Surgeons National Quality Improvement Program (NSQIP) database was used to identify a total of 8029 patients who underwent UKA from January 1, 2008, to December 31, 2016. The database was queried for over 30 unique complications occurring within 30 days. The impact of BMI on short-term outcomes was assessed as a categorical variable using univariate and multivariate regression. Additionally, BMI was assessed as a continuous variable using spline regressions. RESULTS: Univariate regression analysis revealed that compared to normal weight patients, overweight patients had a lower risk of major complication (odds ratio [OR], 0.506; 95% confidence interval [CI], 0.279-0.918; p = 0.025), and any complication ([OR] 0.632; 95% CI, 0.423-0.944; p = 0.025) Multivariate regression analysis found no statistically significant relationship between categorical BMI and complications or outcomes, except for morbidly obesepatients who had a greater risk of superficial SSI (p = 0.026). Spline regression found no statistically significant non-linear relationships between BMI and any complication (p = 0.4687), major complications (p = 0.1567), or minor complications (p = 0.4071). CONCLUSION: Overweight and obese individuals who undergo UKA may not have an increased risk of 30-day postoperative complications compared to normal weight individuals.
Authors: Hasan Raza Mohammad; Stephen Mellon; Andrew Judge; Christopher Dodd; David Murray Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-04-17 Impact factor: 4.342
Authors: Kevin F Purcell; Benjamin M Stronach; Marie Gene Almand; Doug Parsell; Trevor Pickering; R Kerk Mehrle; Craig Winkler; Jeff D Almand Journal: Arthroplast Today Date: 2021-06-23