Journal
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME
Volume 94B, Issue 10, Pages 1351-1355Publisher
BRITISH EDITORIAL SOC BONE JOINT SURGERY
DOI: 10.1302/0301-620X.94B10.28894
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A total of 445 consecutive primary total knee replacements (TKRs) were followed up prospectively at six and 18 months and three, six and nine years. Patients were divided into two groups: non-obese (body mass index (BMI) < 30 kg/m(2)) and obese (BMI >= 30 kg/m(2)). The obese group was subdivided into mildly obese (BMI 30 to 35 kg/m(2)) and highly obese (BMI >= 35 kg/m(2)) in order to determine the effects of increasing obesity on outcome. The clinical data analysed included the Knee Society score, peri-operative complications and implant survival. There was no difference in the overall complication rates or implant survival between the two groups. Obesity appears to have a small but significant adverse effect on clinical outcome, with highly obese patients showing lower function scores than non-obese patients. However, significant improvements in outcome are sustained in all groups nine years after TKR. Given the substantial, sustainable relief of symptoms after TKR and the low peri-operative complication and revision rates in these two groups, we have found no reason to limit access to TKR in obese patients.
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