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BMC Surgery
Published in: BMC Surgery 1/2022

Open Access 01-12-2022 | Obesity | Research

Obesity paradox among patients undergoing total knee arthroplasty: a retrospective cohort study

Authors: Lulu Ma, Xuerong Yu, Xisheng Weng, Jin Lin, Wenwei Qian, Yuguang Huang

Published in: BMC Surgery | Issue 1/2022

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Abstract

Background

Obesity has been recognized as the risk factor for postoperative complication for surgical patients. However, recent studies have showed protective effect of obesity in surgical and non-surgical patients. Our study is to examine the association of body mass index(BMI) with early postoperative complications in patients undergoing total knee arthroplasty.

Materials and methods

All patients who had primary total knee arthroplasty between January 2014 and December 2019 were included. Medical records were retrospectively reviewed and BMI was categorized as underweight(BMI < 18.5), normal weight(18.5 < BMI < 24.9), overweight I(25 < BMI < 27.4), overweight II(27.5 < BMI < 29.9), obese I(30 < BMI < 34.9) and obese II(BMI ≥ 35). The association between BMI and occurrence of early postoperative complications was examined and logistic regression was used to calculate relationship between BMI and early postoperative complications.

Results

A total of 2969 patients were included in our analysis. The overall complication rate in patients undergoing total knee arthroplasty was 14.8%, with the highest complication being 22.2% in the underweight group, the second highest in the normal weight group(17.5%), the lowest in the overweight I(13.8%) and obese I(12.0%) group and then higher again in obese II group(16.7%). In multivariable analyses, overweight I (OR 0.737, 95% CI 0.559–0.972, P = 0.031) and obese I (OR 0.631, 95% CI 0.449–0.885, P = 0.008) were associated with lower risk of early postoperative complications after total knee arthroplasty.

Conclusion

In this retrospective study, overweight and obese patients had a lower risk of early postoperative complications after total knee arthroplasty. Further studies are necessary to confirm and investigate the mechanism of obesity paradox in this surgical population.

Trial registration

This study had been registrated in www.​chictr.​org.​cn on 25/10/2021 and the registration ID was ChiCTR2100052408.
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Metadata
Title
Obesity paradox among patients undergoing total knee arthroplasty: a retrospective cohort study
Authors
Lulu Ma
Xuerong Yu
Xisheng Weng
Jin Lin
Wenwei Qian
Yuguang Huang
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2022
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-022-01806-6

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