Abstract
Longitudinal data on patient trends in body mass index (BMI) and the proportion that
gains or loses significant weight before and after total knee arthroplasty (TKA) are
scarce. This study aimed to observe patients longitudinally for a 2-year period and
determine (1) clinically significant BMI changes during the 1 year before and 1 year
after TKA and (2) identify factors associated with clinically significant weight changes.
A prospective cohort of 5,388 patients who underwent primary TKA at a tertiary health
care institution between January 2016 and December 2019 was analyzed. The outcome
of interests was clinically significant weight changes, defined as a ≥5% change in
BMI, during the 1-year preoperative and postoperative periods, respectively. Patient-specific
variables and demographics were assessed as potential predictors of weight change
using multinomial logistic regression.
Overall, 47% had a stable weight throughout the study period (preoperative: 17% gained,
15% lost weight; postoperative: 19% gained, 16% lost weight). Patients who were older
(odds ratio [OR] = 0.95), men (OR = 0.47), overweight (OR = 0.36), and Obese Class
III (OR = 0.06) were less likely to gain weight preoperatively. Preoperative weight
loss was associated with postoperative weight gain 1 year after TKA (OR = 3.03). Preoperative weight gain was associated with postoperative weight loss 1 year after TKA (OR = 3.16).
Most patients maintained a stable weight before and after TKA. Weight changes during
the 1 year before TKA were strongly associated with reciprocal rebounds in BMI postoperatively,
emphasizing the importance of ongoing weight management during TKA and the recognition
of patients at higher risk for weight gain.
Level of evidence II (prospective cohort study).
Keywords
TKA - BMI - weight change - weight trend - predictors
