Clin Orthop Surg.  2018 Sep;10(3):315-321. 10.4055/cios.2018.10.3.315.

Does Obesity Affect Clinical and Radiological Outcomes in Minimally Invasive Total Knee Arthroplasty? Minimum 5-Year Follow-up of Minimally Invasive TKA in Obese Patients

• Yoo JH
• Oh HC
• Park SH
• Kim JK
• Kim SH

• KMID: 2418751
• DOI: http://doi.org/10.4055/cios.2018.10.3.315

Abstract

BACKGROUND
The aim of this study was to evaluate the clinical and radiological outcomes of minimally invasive total knee arthroplasty (MIS-TKA) in obese patients.
METHODS
We examined the records of 371 cases of MIS-TKA performed using the mini-midvastus approach from January 2006 to December 2006. According to body mass index (BMI), the cases were classified into group A (BMI < 25 kg/m2, 114 knees), group B (25 kg/m2 ≤ BMI < 30 kg/m2, 179 knees), and group C (BMI ≥ 30 kg/m2, 78 knees). Clinical outcomes were measured with the Hospital for Special Surgery Score and Knee Society Score. Radiological evaluation included measurements of knee alignment.
RESULTS
MIS-TKA was performed on all patients. The skin incision size in group A, group B, and group C was 8.2 ± 0.8 cm, 8.3 ± 0.8 cm, and 8.5 ± 0.9 cm, respectively, and the operation time was 86.4 ± 10.4 minutes, 85.9 ± 11.3 minutes, and 89.0 ± 11.4 minutes, respectively, indicating no significant difference among the groups (p > 0.05). There was no difference in terms of the accuracy of the tibial implant alignment, with 97.6%, 95.2%, and 93.4% of each group showing 90°± 3° varus angulation (p > 0.05). With respect to the accuracy of the femorotibial angle, 93.9%, 94.6%, and 90.2% of each group had 6°± 3° valgus angulation, with group C demonstrating the lowest level of accuracy (p < 0.05). The preoperative range of motion and Knee Society Score of group C were less than those of groups A and B (p < 0.05), but there was no notable difference among groups at the postoperative 3-month and 1-year follow-ups (p > 0.05).
CONCLUSIONS
MIS-TKA in obese patients showed satisfactory clinical and radiological results without significant difference in surgical results compared to nonobese patients.

Keyword

Knee arthroplasty; Minimal invasive surgery; Body mass index

MeSH Terms

Arthroplasty, Replacement, Knee*
Body Mass Index
Follow-Up Studies*
Humans
Knee
Obesity*
Range of Motion, Articular
Skin

Figure

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  Fig. 1 (A) Anteroposterior radiograph of a well-fixed NexGen Legacy posterior stabilized flex fixed bearing and modular tibial implant total knee prosthesis in a 79-year-old female with a body mass index of 28.2 kg/m2 (weight, 79 kg; height, 1.47 m). (B) Lateral radiograph showing the skin incision length of 8.5 cm.

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