The Knee, ISSN: 0968-0160, Vol: 27, Issue: 6, Page: 1899-1906

Is obesity associated with short-term revision after total knee arthroplasty? An analysis of 121,819 primary procedures from the Dutch Arthroplasty Register

Rassir, Rachid; Sierevelt, Inger N; van Steenbergen, Liza N; Nolte, Peter A
Knee

Background

The prevalence of obesity is increasing. The association with knee osteoarthritis is well documented, resulting in the population requesting total knee arthroplasty (TKA) for invalidating symptoms to be heavier in nature. The purpose of the current analysis was to assess the association between preoperative body mass index (BMI) and short-term revision rate after TKA. The secondary aim was to investigate the influence of implant fixation method on the association between BMI and survivorship.

Methods

This is a retrospective analysis of prospectively collected registry data (Dutch Arthroplasty Register; LROI). All primary TKA procedures in patients >18 years of age with registered BMI were selected ( n = 121,819). Non-obese patients (BMI 18–25) were compared with overweight (BMI 25–30) and class I–III obese (BMI >30, >35, >40) patients. Crude all-cause revision rates were calculated using competing risk analysis. Adjusted hazard ratios (HRs) were determined with Cox multivariable regression analyses for all-cause, septic and aseptic revision and secondary patellar resurfacing.

Results

Revision rates were 3.3% for non-obese patients, 3.5% for overweight patients, 3.7% for class I obese patients, 3.6% for class II obese patients and 3.7% for class III obese patients. Class III obese patients had a significant higher risk for septic revision compared with non-obese patients (HR 1.53, 95% confidence interval (CI) 1.06–2.22). Class I obese patients had a higher risk for secondary patellar resurfacing (HR 1.52, 95% CI 1.12–2.08). All-cause and aseptic revision rates were similar between BMI groups.

Conclusions

Obesity appeared to be associated with some short-term revision risks after TKA, but was not associated with an overall increase in revision rate.

Download article