The impact of obesity on the mid-term outcome of cementless total knee replacement

Abstract Introduction: Total knee replacement is a reliable operation for reducing pain and improving function in severe osteoarthritis of the knee. As incidence of obesity is increasing worldwide, there is a debate about the role of Body Mass Index (BMI) in selection of patients requiring total knee replacement. The aim of the study was to evaluate the impact of body mass index on total knee replacement in terms of post-operative improvement in knee range of motion, patient satisfaction and complications.Material and methods: Out of 175 patients who suffered from advance knee osteoarthritis and were candidates for primary total knee replacement from January 2016 to March 2018, 155 patients fit the inclusion criteria. Group 1 included 66 patients who were overweight and class 1 obese while group 2 included 89 patients who were class 2 and 3 obese according to WHO Body Mass Index classification. All patients underwent total knee replacement according to the hospital guidelines. Pre and post-operative range of motion, patient satisfaction and complications were assessed and documented. Results: There was no statistically significant difference in improvements in post-operative knee range of motion between the two groups up to 2 years of follow up. [Mann-Whitney U test p= 0.069]. Similarly, Mann-Whitney U test showed that there is no significant difference between patient satisfaction levels (SF-12 scores) of the two groups (p= 0.09). Conclusion: There is no significant impact of obesity on outcomes after total knee replacement and BMI should not be used as a factor in selecting patients who qualify for total knee replacement.Level of Evidence: Level III

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Profile of total knee replacement patients and short term outcome in the sanglah public hospital 2018: a case reports

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20202918 ◽

2020 ◽

Vol 8 (7) ◽

pp. 2684

Author(s):

I. Wayan Suryanto Dusak ◽

Dwiwahyonokusuma . ◽

I. Gusti Ngurah Paramartha Wijaya Putra

Keyword(s):

Total Knee Replacement ◽

Knee Replacement ◽

Case Reports ◽

Normal Weight ◽

Short Term ◽

Term Outcome ◽

Short Term Outcome ◽

Obese Class ◽

Total Knee

Total knee replacement (TKR) is considered to be among the most successful type of orthopedic surgery, with 15-year-survival-rate of implant exceeding 95%; furthermore, the improvement in quality of life is very significant. This study aims to describe the demographics, length of hospitalization and short-term outcome observed in patients undergoing TKR at Sanglah Hospital in 2018. All patients undergoing TKR at Sanglah Hospital in 2018 have been prospectively entered into our database. A total of 59 patients were recorded on 2018 for this study and 1 revision TKR patient and 2 patients with incomplete data were excluded. At baseline, 78.6% patients were female, 72.3% were Balinese and 84.1% were housewives. The mean age of patients was 63 years old. Authors also record that 44 (78.6%) patients are Overweight patients (BMI 25.00-29.99 kg/m2), 11 (19.6%) patients are at Obese Class I (30.00-34.99 kg/ m2) range, and only 1 (1.8%) patients have normal weight (18.50-24.99 kg/m2). As many as 51.8% patients had right TKR and 49.2% left TKR. The modus of patient’s length of stay is 7 days with 27 (48.2%) patients started to walk on the 4th day. VAS was recorded at level 4/10 on 92.9% patient. Drain was removed after 3 days on 42 (75%) patients. 15 patients (26.8%) had PRC transfusion due to anemia after operation.

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The effect of numbness on outcome from total knee replacement

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2017.0026 ◽

2017 ◽

Vol 99 (5) ◽

pp. 385-389 ◽

Cited By ~ 5

Author(s):

J Blackburn ◽

V Wylde ◽

R Greenwood ◽

AW Blom ◽

A Levy

Keyword(s):

Total Knee Replacement ◽

Knee Replacement ◽

Functional Limitations ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Self Report ◽

Pain Subscale ◽

Patient Reported ◽

Total Knee ◽

The Impact

INTRODUCTION Some patients report continuing pain and functional limitations after total knee replacement (TKR). While numbness around the TKR scar is common, the impact of numbness is less clear. One particular activity that could be influenced by numbness is kneeling. The aim of this study was to explore the impact of numbness around TKR scars on health related quality of life and kneeling ability. METHODS Fifty-six patients were recruited one year after primary TKR. Sensation around the knee was assessed through patient self-reporting, monofilament testing and vibration, and patients’ distress was measured on a visual analogue scale. Patient reported outcome measures (PROMs) including the Western Ontario and McMaster Universities (WOMAC®) index, the Knee injury and Osteoarthritis Outcome Score (KOOS), the painDETECT® (Pfizer, Berlin, Germany) questionnaire and the EQ-5D™ (EuroQol, Rotterdam, Netherlands) questionnaire were used. Participants were also asked about kneeling ability. RESULTS While 68% of patients reported numbness around their TKR scar, there was no statistically significant correlation between numbness and distress at numbness (self-report: 0.23, p=0.08; monofilament: 0.15, p=0.27). Furthermore, numbness did not correlate significantly with joint specific PROMs (WOMAC®: 0.21, p=0.13; KOOS: 0.18, p=0.19). However, difficulty with kneeling did correlate with both self-reported numbness (0.36, p=0.020) and worse PROM scores (WOMAC® pain subscale: 0.62, p<0.001; KOOS: 0.64, p<0.001). CONCLUSIONS Numbness after knee replacement is common but is not associated with worse patient reported outcomes.

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Factors influencing the long-term outcome of primary total knee replacement in haemophiliacs: a review of 116 procedures at a single institution

British Journal of Haematology ◽

10.1111/j.1365-2141.2009.07613.x ◽

2009 ◽

Vol 145 (2) ◽

pp. 227-234 ◽

Cited By ~ 59

Author(s):

Luigi P. Solimeno ◽

Maria E. Mancuso ◽

Gianluigi Pasta ◽

Elena Santagostino ◽

Samantha Perfetto ◽

...

Keyword(s):

Total Knee Replacement ◽

Knee Replacement ◽

Single Institution ◽

Term Outcome ◽

Long Term Outcome ◽

Factors Influencing ◽

Primary Total Knee Replacement ◽

Total Knee ◽

Primary Total Knee

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Long-term outcome in an uncemented, hydroxyapatite-coated total knee replacement

Journal of Bone and Joint Surgery - British Volume ◽

10.1302/0301-620x.94b8.28350 ◽

2012 ◽

Vol 94-B (8) ◽

pp. 1067-1070 ◽

Cited By ~ 31

Author(s):

J. T. K. Melton ◽

R. Mayahi ◽

S. E. Baxter ◽

M. Facek ◽

C. Glezos

Keyword(s):

Total Knee Replacement ◽

Knee Replacement ◽

Term Outcome ◽

Long Term Outcome ◽

Total Knee

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COST-UTILITY ANALYSIS OF PRIVATE CONTRACTING TO REDUCE PUBLIC WAITING TIMES FOR JOINT REPLACEMENT SURGERY

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462317004524 ◽

2018 ◽

Vol 34 (2) ◽

pp. 147-155

Author(s):

Jonathan Karnon ◽

Bahareh Mesgarian Haghighi ◽

Babu Sajjad ◽

Sokunthea Yem ◽

Anuji Gamage ◽

...

Keyword(s):

Total Knee Replacement ◽

Knee Replacement ◽

Waiting Times ◽

Publicly Funded ◽

Knee Replacement Surgery ◽

Replacement Surgery ◽

Total Knee Replacement Surgery ◽

Total Knee ◽

The Impact ◽

Private Contracting

Objectives:Earlier treatment of publicly funded patients may achieve health gains that justify the additional costs of reducing waiting times. This study reports on the cost-effectiveness of implementing a private contracting model to meet alternative maximum waiting time targets for publicly funded patients undergoing total knee replacement surgery in Australia.Methods:A linked decision tree and cohort Markov model was developed and populated and validated using secondary data sources to represent the pathways, costs, and quality adjusted life-years (QALYs) gained of non-urgent patients with alternative waiting times for total knee replacement surgery to a maximum age of 100 years.Results:Assuming public waiting times are reduced through the purchase of private services, additional QALYs are gained at an incremental cost of less than $40,000. Value could be increased if lower private prices could be negotiated. Results are also sensitive to the rate of deterioration in function while waiting for surgery and the impact of functional status at the time of surgery on postsurgery outcomes.Conclusions:More evidence on the value of expanded capacity or new models of care may inform new funding models to support such investments and reduced prices for new technologies, leading to more efficient and sustainable publicly funded healthcare systems.

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