Abstract
Introduction: Total knee arthroplasty in obese patients remains a challenge to most surgeons. Surgical complication rates as well as perioperative morbidity are higher than total knee arthroplasty in the nonobese. The purpose of this paper is to review our experience with total knee arthroplasty in superobese patients (BMI> 50).
Methods: From 1998–2005, 84 patients underwent 148 knee arthroplasties. Sixty-four patients underwent simultaneous bilateral total knee arthroplasties and 20 patients underwent unilateral knee arthroplasties. They were compared with similar group of nonobese patients who underwent knee arthroplasties during the same time period. All patients received combined regional and general anesthesia.
Results: Mean follow-up was 3.8 years (2–7). Knee society scores improved by 36 points in the superobese (pre-op 47 to 83 post-op) and by 45 points in the non-obese (pre-op 47 to 93 post-op) (p< .05). There was a greater incidence of complications in the superobese group, namely superficial wound infections and deep vein thrombosis. There was late loosening in three tibial components and instability in two patients that required revision in the superobese group. No reoperations in the nonobese group.
Conclusion: Although total knee arthroplasty may be safely performed in the superobese, it may be complicated by infection, loosening, instability, and lower knee scores.
Correspondence should be addressed to: EFORT Central Office, Technoparkstrasse 1, CH – 8005 Zürich, Switzerland. Email: office@efort.org
