2009 Annual Meeting Podium Presentations

Adult Reconstruction Knee 3: Complications

Complications Following Total Knee Arthroplasty in the Superobese, BMI>50

Podium No: 280

Thursday, February 26, 2009
11:42 AM - 11:48 AM

Location: Venetian Hotel
Room 2201

David J Polga, MD Rochester MN
Aaron Altenburg, MD Pocatello ID
Robert T Trousdale, MD Rochester MN
David G Lewallen, MD Rochester MN

Moderator(s):
Michael A Kelly, MD Hackensack NJ
William Michael Mihalko, MD, PhD Memphis TN

We conclude that while technically feasible, TKA in superobese patients (BMI >50) is associated with an alarmingly high complication rate.

To our knowledge there have been no published results on the outcomes of total knee arthroplasty (TKA) in the superobese patient.

We retrospectively reviewed 133 knees in 105 patients undergoing primary TKA from 1996 ' 2006 with a mean BMI of 53.6 (50-65.9). The mean age at time of index arthroplasty was 60.73 (42-84) with a mean follow-up of 35.6 months.

Overall, there were 54 (40.6%) surgical complications and 15 (14.3%) medical complications including 2 perioperative deaths. Surgical complications included 20 knees with prolonged wound drainage, 4 knees with cellulitis or stitch abscesses, and 6 legs with residual neuropathy for a minor complication rate of 22.6%. There were 19 (14.3%) reoperations/major complications including 9 irrigation and debridements with component retention, 6 resection arthroplasties for deep infection, 2 revisions for aseptic loosening or malalignment, 1 revision for periprosthetic fracture, and 1 quadriceps tendon rupture. There were 5 intra-operative complications in 4 patients.

We conclude that while technically feasible, TKA in superobese patients (BMI >50) is associated with an alarmingly high complication rate. Patients should be counseled preoperatively regarding these risks and encouraged to lose weight or referred to a bariatric specialist optimally.

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