Evaluation of effects of BMI on Functional Recovery Following Total Knee Arthroplasty Surgery

Volume : VII, Issue : IV, April - 2018

Dr. Anurag Chandrakar, Dr. Pratik Kawde

Background: Obesity is a well known risk factor for complications following total knee arthroplasty, various data is

available on the impact of the degree of obesity on patient-reported outcomes following total knee arthroplasty.

In our study we tried to determine the extent to which obesity level affects the recovery as well as patient-reported pain, function, and

satisfaction with after total knee arthroplasty surgery.

Methods: We followed a cohort of patients who underwent total knee arthroplasty at our medical centre. Patients included were +40 years

of age with a primary diagnosis of osteoarthritis. Patients were classi􀃶ed into 5 groups according to the World Health Organization

classi􀃶cation of body mass index (BMI). Assessment was done between BMI group and pain and function over the time intervals of 0 to 3, 3

to 6, and 6 to 12 months using a piecewise linear model. Multivariable models adjusted for age, sex, diabetes, musculoskeletal functional

limitations index and pain medication use.

Results: Of the 150 participants included in our analysis, 19% were normal weight (BMI of <25 kg/m2), 32% overweight (BMI of 25 to 29.9

kg/m2), 27% class-I obese (BMI of 30 to 34.9 kg/m2), 12% class-II obese (BMI of 35 to 39.9 kg/m2), and 9% class-III obese (BMI of +40 kg/m2).

Study participants with worse preoperative WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) had a higher BMI,

pain and function scores and had greater improvement from baseline to 3 months. Across all BMI groups the mean change in pain and

function from 3 to 6 and from 6 to 12 months was similar. At 12 months, participants in all BMI groups had similar levels of pain, function, and

satisfaction.

Conclusions: The variability of recovery in the 􀃶rst 3 months following total knee arthroplasty , the participants in the higher BMI groups

were able to attain absolute pain and function scores similar to those in the non obese and class-I obese groups. The available data can be

helpful for surgeons to discuss with the patients about their demands and functional recovery following Total knee Arthroplasty surgery,