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General Orthopaedics

GUIDED MOTION TOTAL KNEE ARTHROPLASTY IN PATIENTS WITH BODY MASS INDEX OF 40 KG/M2 OR MORE: RESULTS FROM THE INTERNATIONAL MULTICENTRE STUDY OF 2,059 PRIMARY TOTAL KNEE ARTHROPLASTIES WITH UP TO SIX YEARS’ FOLLOW-UP

International Society for Technology in Arthroplasty (ISTA) meeting, 32nd Annual Congress, Toronto, Canada, October 2019. Part 1 of 2.



Abstract

Introduction/Aim

Outcomes for guided motion primary total knee arthroplasty (TKA) in obese patients are unknown.

Materials and Methods

1,684 consecutive patients underwent 2,059 primary TKAs with a second-generation guided motion implant (Journey II Bi-Cruciate Stabilized Knee System, Smith & Nephew, Inc., Memphis) between 2011–2017 at three European and seven US sites.

Results

Of 2,003 (97.3%) TKAs in 1,644 patients with BMI data: average age 64.5 years; 58.4% females; average BMI 32.5 kg/m2;13.4% had BMI ≥ 40 kg/m2. Subjects with BMI ≥ 40 kg/m2 had longest length of hospital stay (LOS) at European sites; LOS similar at US sites. Subjects with BMI ≥ 40 kg/m2 (P=0.0349) had longest surgery duration. BMI ≥ 40 kg/m2 had more re-hospitalizations or post-TKA reoperations than BMI < 40 kg/m2 (12.7% and 9.2% at five-year post-TKA, P<.0495). 62 TKAs were revised (3.39/100 TKA at five years) with no differences in revision risk between groups. 17 (27.4%) revisions involved femoral or tibial component removal; 45 (72.6%) involved tibial insert or patellar component removal only with revision risk similar between groups.

Discussion

Our results corroborate literature-reported revision outcomes of standard TKAs in obese patients.

Conclusion

Surgery duration and long-term complication rates are higher in patients with BMI ≥ 40 kg/m2, but device revision risk is not elevated.