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General Orthopaedics

SHOULD MORBIDLY OBESE AND OBESE PATIENTS BE OFFERED DAYCASE KNEE SURGERY?: A TWELVE-YEAR EXPERIENCE AT TORBAY HOSPITAL DAYCASE UNIT

The South West Orthopaedic Club (SWOC)



Abstract

Literature has suggested that obese (BMI >30) and morbidly obese (BMI > 35) patients should not be offered surgery as a day case due to increases in complication and readmission rates. At Torbay hospital, patients are routinely offered day case surgery, in a specialist day case unit, regardless of BMI. This is done with minimal complications and enables a higher throughput of patients and at least 75% of surgical procedures to be performed as a day case, as per NHS guidelines.

We present 12 year data of day case knee arthroscopy surgery performed at Torbay hospital. Over 12 years, 3421 knee arthroscopies were performed. 649 were performed on obese patients and 222 on morbidly obese patients. No anaesthetic complications were observed in any of the obese patient groups and readmissions rates (up to 28 days) were 0.8% in the morbidly obese group and 0.9% in the Obese group, compared to 0.9% for patients with BMI <30.

Our data shows that day case surgery can be performed on all patients regardless of BMI and patient obesity. We believe that other units should offer surgery to obese and morbidly obese patients to allow increased efficiency and achievement of NHS day case guidelines.