Tohidi M, et al. - Researchers ascertained the relationship between morbid obesity and 10-year survival and revision surgery in patients who underwent primary total knee arthroplasty (TKA). A 50% higher 10-year risk of death was seen in morbidly obese patients ≤60 years old, but they did not note any difference in the risk of revision surgery. Evidence-based perioperative counseling of morbidly obese patients considering TKA was informed by the findings.

Methods

• Authors conducted a cohort study of 9,817 patients 18-60 years of age treated with primary TKA from April 1, 2002 to March 31, 2007 using Ontario administrative healthcare databases of universal health care coverage.
• They followed the Patients for 10 years after TKA.
• Experts estimated the risk ratios (RRs) of mortality and TKA revision surgery in patients with body mass index (BMI) > 45 kg/m² (morbidly obese patients) vs BMI ≤45 kg/m² (non-morbidly obese) adjusting for age, sex, socioeconomic status, and comorbidities.

Results

• As per the findings, 10.2% of the cohort (1,001) was morbidly obese.
• Results suggested more likeliness of the morbidly obese patients to be female than non-morbidly obese patients (82.5% vs 63.7%, p < .001), but otherwise similar in characteristics.
• They noted a higher 10-year risk of death in morbidly obese patients vs non-morbidly obese patients (adjusted RR 1.50, 95% CI 1.22 to 1.85).
• At least 1 revision procedure in the 10 years following TKA was seen in 8.5% of patients (832); revision rates did not differ by obesity (adjusted RR 1.09, 95% CI 0.88 to 1.34).