The MEDLINE database was searched using the key words: ‘obesity’ and ‘knee arthroplasty’. 41 articles focused on the topic were reviewed; most studies were prospective case series (providing low-level evidence) and 3 were systematic reviews. 16 studies reported no adverse association between obesity and total knee arthroplasty (TKA) outcome, whereas 24 studies reported a poorer TKA outcome in obese patients. In the 3 systematic reviews, obesity was reported to adversely affect the outcome, the rate of complications, implant survival, and the cost of TKA.
MarcacciMIaconoFZaffagniniSVisaniALoretiIPetittoA. Total knee arthroplasty without patellar resurfacing in active and overweight patients. Knee Surg Sports Traumatol Arthrosc1997;5:258–61.
3.
HamouiNKantorSVinceKCrookesPF. Long-term outcome of total knee replacement: Does obesity matter?Obes Surg2006;16:35–8.
4.
DeshmukhRGHayesJHPinderIM. Does body weight influence outcome after total knee arthroplasty? A 1-year analysis. J Arthroplasty2002;17:315–9.
5.
BourneRBMcCaldenRWMacDonaldSJMoketeLGuerinJ. Influence of patient factors on TKA outcomes at 5 to 11 years follow up. Clin Orthop Relat Res2007;464:27–31.
6.
ErsozluSAkkayaTOzgurAFSahinOSenturkITandoganR. Bilateral staged total knee arthroplasty in obese patients. Arch Orthop Trauma Surg2008;128:143–8.
7.
Stevens-LapsleyJEPettersonSCMiznerRLSnyder-MacklerL. Impact of body mass index on functional performance after total knee arthroplasty. J Arthroplasty2010;25:1104–9.
8.
SinghJAGabrielSELewallenDG. Higher body mass index is not associated with worse pain outcomes after primary or revision total knee arthroplasty. J Arthroplasty2011;26:366–74.
9.
SuleimanLIOrtegaGOng'utiSKGonzalezDOTranDDOnyikeA. Does BMI affect perioperative complications following total knee and hip arthroplasty?J Surg Res2012;174:7–11.
10.
Abd RazakHR BinChongHCTanAH. Obesity does not imply poor outcomes in Asians after total knee arthroplasty. Clin Orthop Relat Res2013;471:1957–63.
11.
PatelADAlbrizioM. Relationship of body mass index to early complications in knee replacement surgery. Arch Orthop Trauma Surg2008;128:5–9.
12.
RajgopalVBourneRBChesworthBMMacDonaldSJMcCaldenRWRorabeckCH. The impact of morbid obesity on patient outcomes after total knee arthroplasty. J Arthroplasty2008;23:795–800.
13.
BordiniBSteaSCremoniniSVicecontiMDe PalmaRToniA. Relationship between obesity and early failure of total knee prostheses. BMC Musculoskelet Disord2009;10:29.
14.
YeungEJacksonMSextonSWalterWZicatBWalterW. The effect of obesity on the outcome of hip and knee arthroplasty. Int Orthop2011;35:929–34.
15.
BakerPPetheramTJamesonSReedMGreggPDeehanD. The association between body mass index and the outcomes of total knee arthroplasty. J Bone Joint Surg Am2012;94:1501–8.
16.
CollinsRAWalmsleyPJAminAKBrenkelIJClaytonRA. Does obesity influence clinical outcome at nine years following total knee replacement?J Bone Joint Surg Br2012;94:1351–5.
17.
BakerPMuthumayandiKGerrandCKleimBBettinsonKDeehanD. Influence of body mass index (BMI) on functional improvements at 3 years following total knee replacement: A retrospective cohort study. PLoS One2013;8:e59079.
18.
NambaRSPaxtonLFithianDCStoneML. Obesity and perioperative morbidity in total hip and total knee arthroplasty patients. J Arthroplasty2005;20(7Suppl 3):46–50.
19.
GuanZChenYSongY. Influence of body mass index and age on deep vein thrombosis after total hip and knee arthroplasty [in Chinese]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi2006;20:611–5.
20.
GillespieGNPorteousAJ. Obesity and knee arthroplasty. Knee2007;14:81–6.
21.
MulhallKJGhomrawiHMMihalkoWCuiQSalehKJ. Adverse effects of increased body mass index and weight on survivorship of total knee arthroplasty and subsequent outcomes of revision TKA. J Knee Surg2007;20:199–204.
22.
MoonHKHanCDYangIHChaBS. Factors affecting outcome after total knee arthroplasty in patients with diabetes mellitus. Yonsei Med J2008;49:129–37.
23.
DowseyMMChoongPF. Obese diabetic patients are at substantial risk for deep infection after primary TKA. Clin Orthop Relat Res2009;467:1577–81.
24.
YasunagaHTsuchiyaKMatsuyamaYOheK. Analysis of factors affecting operating time, postoperative complications, and length of stay for total knee arthroplasty: Nationwide web-based survey. J Orthop Sci2009;14:10–6.
25.
KimSH. Morbid obesity and excessive hospital resource consumption for unilateral primary hip and knee arthroplasty. J Arthroplasty2010;25:1258–66.
26.
JärvenpääJKettunenJKrögerHMiettinenH. Obesity may impair the early outcome of total knee arthroplasty. Scand J Surg2010;99:45–9.
27.
DowseyMMLiewDChoongPF. Economic burden of obesity in primary total knee arthroplasty. Arthritis Care Res (Hoboken)2011;63:1375–81.
28.
JärvenpääJKettunenJSoininvaaraTMiettinenHKrögerH. Obesity has a negative impact on clinical outcome after total knee arthroplasty. Scand J Surg2012;101:198–203.
29.
McElroyMJPivecRIssaKHarwinSFMontMA. The effects of obesity and morbid obesity on outcomes in TKA. J Knee Surg2013;26:83–8.
30.
IssaKPivecRKapadiaBHShahTHarwinSFDelanoisRE. Does obesity affect the outcomes of primary total knee arthroplasty?J Knee Surg2013;26:89–94.
31.
LiljensøeALauersenJOSøballeKMechlenburgI. Overweight preoperatively impairs clinical outcome after knee arthroplasty: A cohort study of 197 patients 3–5 years after surgery. Acta Orthop2013;84:392–7.
32.
SamsonAJMercerGECampbellDG. Total knee replacement in the morbidly obese: A literature review. ANZ J Surg2010;80:595–9.
33.
SchwarzkopfRThompsonSLAdwarSJLiublinskaVSloverJD. Postoperative complication rates in the “super-obese” hip and knee arthroplasty population. J Arthroplasty2012;27:397–401.
34.
JonesCACoxVJhangriGSSuarez-AlmazorME. Delineating the impact of obesity and its relationship on recovery after total joint arthroplasties. Osteoarthritis Cartilage2012;20:511–8.
35.
KerkhoffsGMServienEDunnWDahmDBramerJAHaverkampD. The influence of obesity on the complication rate and outcome of total knee arthroplasty: A meta-analysis and systematic literature review. J Bone Joint Surg Am2012;94:1839–44.
36.
LiabaudBPatrickDAJrGellerJA. Higher body mass index leads to longer operative time in total knee arthroplasty. J Arthroplasty2013;28:563–5.
37.
BozicKJLauEOngKChanVKurtzSVailTP. Risk factors for early revision after primary total hip arthroplasty in Medicare patients. Clin Orthop Relat Res2014;472:449–54.
38.
FriedmanRJHessSBerkowitzSDHomeringM. Complication rates after hip or knee arthroplasty in morbidly obese patients. Clin Orthop Relat Res2013;471:3358–66.
39.
PruzanskyJSBronsonMJGrelsamerRPStraussEMouchaCS. Prevalence of modifiable surgical site infection risk factors in hip and knee joint arthroplasty patients at an urban academic hospital. J Arthroplasty2014;29:272–6.
40.
EstesCSSchmidtKJMcLemoreRSpangehlMJClarkeHD. Effect of body mass index on limb alignment after total knee arthroplasty. J Arthroplasty2013;28(8 Suppl):101–5.
41.
OdumSMSpringerBDDennosACFehringTK. National obesity trends in total knee arthroplasty. J Arthroplasty2013;28(8 Suppl):148–51.
