Published results showed a higher risk of all-cause revision and revision for infection among patients who were obese and undergoing primary total knee replacement for osteoarthritis compared with patients who were not obese.
Using the Australian Orthopaedic Association National Joint Replacement Registry, Christopher J. Wall, MBBS, BMedSc, FRACS, FAOrthA, and colleagues compared the rates of all-cause revision and revision for infection, loosening, instability and pain between patients who were not obese (BMI of 18.50 kg/m2 to 29.99 kg/m2), patients with class 1 and class 2 obesity (BMI of 30 kg/m2 to 39.99 kg/m2), and patients with class 3 obesity (BMI of 40 kg/m2 or greater) who underwent primary TKR for OA from Jan. 1, 2015, to Dec. 31, 2020. Researchers adjusted results for age, sex, tibial fixation, prothesis stability, patellar component usage and computer navigation use.
Christopher J. Wall
Among the 141,673 patients who underwent primary TKR for OA in Australia during the study period, researchers identified 2,655 revision procedures for infection (39.7%), loosening (14.8%), instability (12%) and pain (6.1%). Results showed a higher risk of all-cause revision and revision for infection among patients with class 1 and class 2 obesity compared with patients who were not obese. Researchers found a higher risk of all-cause revision after 1 year, revision for infection after 3 months and revision for loosening among patients with class 3 obesity vs. patients who were not obese. All groups had similar risks of revision for instability and pain, according to results.
“As the majority of patients undergoing knee replacement are obese (58% in our previous paper), these findings raise concerns for a growing burden of revision knee replacement in the future,” Wall told Healio. “There is an urgent need to address obesity at a societal level in order to reduce the burden of obesity-related knee OA, primary TKR and subsequent revision TKR.”
Wall CJ, et al. ANZ J Surg. 2022;doi:10.1111/ans.17689.
Wall CJ, et al. J Bone Joint Surg Am. 2022;doi:10.2106/JBJS.21.01491.