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J Knee Surg 2023; 36(07): 744-751
DOI: 10.1055/s-0042-1742646
Original Article

Obesity, Comorbidities, and the Associated Risk among Patients Who Underwent Total Knee Arthroplasty in Alberta

Fatemeh Baghbani-Naghadehi 
1   Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
,
Susan Armijo-Olivo
1   Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
2   Faculty of Business and Social Sciences, University of Applied Sciences, Osnabrück, Germany
3   Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
,
Carla M. Prado
4   Department of Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, Alberta, Canada
,
Linda J. Woodhouse
1   Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
5   Department of Public Health and Community Medicine, School of Medicine, Tufts University, Boston, Massachusetts
› Author Affiliations Funding None.
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Abstract

Obesity, a common risk factor for osteoarthritis (OA), accelerates joint deterioration resulting in the need for early total knee arthroplasty (TKA). The role of obesity in the management of OA remains a controversial topic. In this study, we examined whether obesity along with other comorbidities is associated with peri/postoperative complications in patients who underwent primary unilateral TKA in Alberta, Canada. A retrospective secondary analysis was performed on data extracted from data repository of patients (n = 15,151) who underwent TKA between 2012 and 2016. The sample was divided into five groups based on body mass index (BMI) classification developed by the World Health Organization. The associations between dependent variable (presence or absence of a complication or comorbidity) with the independent variables (year of surgery, age, sex, length of surgery, and BMI groups) were examined using binomial logistic regression. Results showed that obese classes I, II, and III, irrespective of other covariates, were more likely to have diabetes and pulmonary embolism (p < 0.001) compared with the normal BMI group. Patients with obese class III compared with the patients in normal BMI group were more likely to have deep wound infection (p = 0.04). Patients with comorbidities were more likely to have a blood transfusion, infection, pulmonary embolism, and readmission. Patients in higher BMI groups or with comorbidities were more likely to experience peri/postoperative complications following TKA, though the level of risk depends on the severity of obesity. These findings may be used by health care providers to educate patients in higher BMI groups about the risks of TKA and optimize comorbidities prior to the surgery.

Keywords

obesity - total knee arthroplasty - osteoarthritis - comorbidities - complications

Ethical Approval and Consent to Participate

The study was approved by the University of Alberta Health Research Ethics Board (ID: Pro00053754), and permission was obtained to extract data from the Alberta Bone and Joint Health Institute (ABJHI) registry. Because of the anonymous nature of the data, the requirement for individual patient written informed consent was waived.


Supplementary Material



Publication History

Received: 29 June 2021

Accepted: 09 December 2021

Article published online:
10 February 2022

© 2022. Thieme. All rights reserved.

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