CORR insights?: Bariatric orthopaedics: Total knee arthroplasty in super-obese patients (BMI > 50 kg/m2). Survivorship and complications

摘要

Where Are We Now?: A Workgroup of the American Association of Hip and Knee Surgeons recently published an evidence-based review of obesity and total joint arthroplasty (TJA) [1]. This well-designed literature review clearly outlines the proportions of this epidemic, and the data presented, frankly, are staggering. The article points out that more than half of patients currently undergoing TJA are obese, and this number is likely to increase. Numerous studies are cited demonstrating obesity to be related to early development of aseptic loosening and infection [2-4, 6-9], as well as poorer functional outcomes following TKA [5, 10, 11]. The Workgroup concluded that compared to a normal-weight population, the degree of functional improvement among obese patients following TJA is smaller than observed in nonobese populations, and that the risks of surgery in this patient population may outweigh the benefits, particularly for the morbidly (BMI > 40) and super-obese (BMI > 50).