Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Mar 18, 2015; 6(2): 284-289
Published online Mar 18, 2015. doi: 10.5312/wjo.v6.i2.284
Total knee arthroplasty: Effect of obesity and other patients’ characteristics on operative duration and outcome
Abdulaziz Saud Al Turki, Yazeed Al Dakhil, Abdulah Al Turki, Mazen Saleh Ferwana
Abdulaziz Saud Al Turki, Yazeed Al Dakhil, Abdulah Al Turki, Department of Orthopedic Surgery, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh 11426, Kingdom of Saudi Arabia
Mazen Saleh Ferwana, Department of Family Medicine and Primary Healthcare King Abdulaziz Medical City, National Guard Health Affairs, Riyadh 11426, Kingdom of Saudi Arabia
Author contributions: Al Turki AS contributed to the conception, designing, interpretation, manuscript drafting and revision; Al Dakhil Y contributed to the data collection; Al Turki A contributed to the interpretation of results and discussion writing; Ferwana MS contributed to the conception, designing, interpretation, manuscript drafting and revision.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Mazen Saleh Ferwana, MD, ABFM, JBFM, PhD, Department of Family Medicine and Primary Healthcare King Abdulaziz Medical City, National Guard Health Affairs, PO Box 22490, Riyadh 11426, Kingdom of Saudi Arabia. ferwanam@ngha.med.sa
Telephone: +966-11-4291159 Fax: +966-11-4299999
Received: May 6, 2014
Peer-review started: May 7, 2014
First decision: May 23, 2014
Revised: September 22, 2014
Accepted: October 14, 2014
Article in press: October 16, 2014
Published online: March 18, 2015
Processing time: 316 Days and 21.3 Hours
Abstract

AIM: To examine the effects of patients’ characteristics mainly obesity on operative duration and other outcome measures of knee arthroplasty.

METHODS: This is a retrospective chart review of 204 patients who had knee arthroplasty within the past five years (2007-2011) at King Abdulaziz Medical City in Riyadh, Kingdom of Saudi Arabia. The data collection form was developed utilizing the literature review to gather all the needed variables. Data were gathered from admission notes, nursing notes, operative reports and discharge summaries.

RESULTS: A feasible sample of 204 patients were included in the study. Of those patients, 155 (76%) were females. The mean age was 70.1 years for males (SD ± 9.4) and 62.7 years (SD ± 8) for females. Regarding the type of total knee replacement (TKR), 163 (79.9%) patients had unilateral TKR and 41 (20.1%) had bilateral TKR. Nine patients (4.4%) had a normal body mass index (BMI) (18.5 to < 25). Overweight patients (BMI 25 to < 30) represented 18.1%. Obesity class I (BMI 30 to < 35) and obesity class II (BMI from 35 to < 40) were present in 23% and 29.9% of the patients, respectively. Morbid obesity (BMI greater than 40) was present in 24.5%. The mean duration of surgery was 126.3 min (SD ± 30.8) for unilateral TKR and 216.6 min (SD ± 55.4) for bilateral TKR.The mean length of stay in the hospital was 12 d (SD ± 4.9). The complications that patients had after the operation included 2 patients (1%) who developed deep venous thrombosis, 2 patients (1%) developed surgical wound infections and none had pulmonary embolism. Patients' characteristics (including age, gender, BMI and co-morbidities) did not have an effect on the operative duration of knee replacement nor the length of hospital stay.

CONCLUSION: Our study shows that obesity and other patients’ characteristics do not have effect on the operative duration nor the length of hospital stay following TKR.

Keywords: Knee; Replacement; Arthroplasty; Implantation; Surgery; Orthopedics; Total knee arthroplasty; Total knee replacements

Core tip: Studying the effects of obesity and other patient’s characteristics on the outcome and operative duration of knee arthroplasty (KA) is of great value for both patients and physicians. Studies regarding this subject have shown conflicting results, and the importance of these factors on the decision to perform KA is debatable among surgeons. In our study, we demonstrated that higher body mass index values were not associated with longer duration of surgery. We also found that patients’ characteristics did not seem to be an important determinant of length of stay.