Abstract
The influence of BMI on outcomes from TKA remains unclear. The purpose of this study was to evaluate if navigation affected the outcomes of TKA in obese patients.
Sixty-four (mean age 65 yrs±7) consecutive computer navigated TKA’s were compared with a matched group of 64 (65yrs±8) conventional TKA’s in patients with a BMI > 35. The groups were matched for age, gender, diagnosis and operative technique. Patients were reviewed pre-operatively and 6 weeks and 1 year post-operatively. All patients had clinical and radiological assessment and were scored using the Oxford knee score.
There were significant improvements (p< 0.001) in all clinical outcomes at 6 weeks and 1 year post-operatively in both groups. No significant differences were found between groups 6 weeks post surgery. The computer navigated group performed significantly better in post operative knee flexion (Nav 99° ± 10, Conv 94° ±12, p< 0.05) and Oxford scores (Nav 20 ± 10, Conv 25±12, p< 0.01) at 1 year compared to the conventional group. There were significantly (p< 0.05) more flexion contractures one year post-operatively in the conventional group which correlated significantly (p< 0.001) with decreased maximal knee flexion at one year.
This study suggests that navigated TKA produces better early clinical outcomes than conventional TKA in the obese patients possibly due to improved sagittal alignment as evidenced by the lack of flexion contractures 1 year post-operatively.
Correspondence should be addressed to: BASK c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.
