Mid- to long-term complications and outcome for morbidly obese patients after total knee arthroplasty: a systematic review and meta-analysis

EFORT Open Reviews

article

Joost van Tilburg¹  Mikkel Rathsach Andersen¹ 

[1] Department of Orthopedics, Herlev Gentofte Hospital

关键词: morbidly obese;    total knee arthroplasty;    total knee replacement;    revision rate;    Knee Society Score;    functional outcome;    complication rate;   

DOI  :  10.1530/EOR-21-0090

学科分类：神经科学

来源: The British Editorial Society of Bone & Joint Surgery

【 摘 要 】

Purpose Due to substantial increase in obesity, the demand for total knee arthroplasty (TKA) in obese and morbidly obese patients is higher than ever. This review aims to investigate mid- to long-term complications, revision rates, and outcome for morbidly obese, compared with non-obese after TKA.MethodsA systematic search was conducted in May 2021. Included studies reported revision rates for morbidly obese and non-obese with a mean follow-up of at least 2 years. Reported knee society score (KSS) has been used to compare the functional outcome. PRISMA protocol was followed, and PROSPERO registered (ID: CRD42021254119).ResultsFrom 12 studies that met the inclusion criteria, a total of 1031 cases of morbidly obese and 9797 cases of non-obese controls were included. The risk ratio for revision was 1.48 for the morbidly obese, compared with non-obese (95% CI: 0.98 to 2.24; P = 0.06). Regarding aseptic and septic revision, the risk ratio was 1.44 (95% CI: 0.64 to 3.25; P  = 0.37) and 2.22 (95% CI: 0.89 to 5.57; P  = 0.09), respectively. The morbidly obese scored lower in Objective Knee Society Score (OKSS) and Functional Knee Society Score (FKSS) both preoperatively and postoperatively, compared with the non-obese; however, the two groups improved equally in function scores OKSS (P= 0.967) and FKSS (P  = 0.834). Overall risk ratio for complications was 1.56 (95% CI: 0.98 to 2.48; P  = 0.06).Conclusions The gained benefit in functional outcome surpasses the increase in risk of revision and complications for the morbidly obese in TKA surgery.

【 授权许可】

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