Document Detail


The influence of obesity on the complication rate and outcome of total knee arthroplasty: a meta-analysis and systematic literature review.
MedLine Citation:
PMID:  23079875     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The increase in the number of individuals with an unhealthy high body weight is particularly relevant in the United States. Obesity (body mass index ≥ 30 kg/m2) is a well-documented risk factor for the development of osteoarthritis. Furthermore, an increased prevalence of total knee arthroplasty in obese individuals has been observed in the last decades. The primary aim of this systematic literature review was to determine whether obesity has a negative influence on outcome after primary total knee arthroplasty.
METHODS: A search of the literature was performed, and studies comparing the outcome of total knee arthroplasty in different weight groups were included. The methodology of the included studies was scored according to the Cochrane guidelines. Data extraction and pooling were performed. The weighted mean difference for continuous data and the weighted odds ratio for dichotomous variables were calculated. Heterogeneity was calculated with use of the I2 statistic.
RESULTS: After consensus was reached, twenty studies were included in the data analysis. The presence of any infection was reported in fourteen studies including 15,276 patients (I2, 26%). Overall, infection occurred more often in obese patients, with an odds ratio of 1.90 (95% confidence interval [CI], 1.46 to 2.47). Deep infection requiring surgical debridement was reported in nine studies including 5061 patients (I2, 0%). Deep infection occurred more often in obese patients, with an odds ratio of 2.38 (95% CI, 1.28 to 4.55). Revision of the total knee arthroplasty, defined as exchange or removal of the components for any reason, was documented in eleven studies including 12,101 patients (I2, 25%). Revision for any reason occurred more often in obese patients, with an odds ratio of 1.30 (95% CI, 1.02 to 1.67).
CONCLUSIONS: Obesity had a negative influence on outcome after total knee arthroplasty.
Authors:
Gino M M J Kerkhoffs; Elvire Servien; Warren Dunn; Diane Dahm; Jos A M Bramer; Daniel Haverkamp
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  The Journal of bone and joint surgery. American volume     Volume:  94     ISSN:  1535-1386     ISO Abbreviation:  J Bone Joint Surg Am     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-19     Completed Date:  2013-01-11     Revised Date:  2013-10-20    
Medline Journal Info:
Nlm Unique ID:  0014030     Medline TA:  J Bone Joint Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1839-44     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopedic Surgery, Orthotrauma Research Center Amsterdam, University of Amsterdam, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. g.m.kerkhoffs@amc.nl
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MeSH Terms
Descriptor/Qualifier:
Arthroplasty, Replacement, Knee*
Body Mass Index
Body Weight
Humans
Obesity / complications*
Osteoarthritis, Knee / complications,  surgery*
Postoperative Complications / etiology*
Prosthesis Failure
Treatment Outcome
Grant Support
ID/Acronym/Agency:
5K23 AR052392-05/AR/NIAMS NIH HHS
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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