Higher body mass index is not associated with worse pain outcomes after primary or revision total knee arthroplasty.

We assessed whether higher body mass index (BMI) is associated with higher risk of moderate-severe knee pain 2 and 5 years after primary or revision total knee arthroplasty (TKA).We adjusted for sex, age, comorbidity, operative diagnosis, and implant fixation in multivariable logistic regression. Body mass index (reference, b 25 kg/m2) was not associated with moderate severe knee pain at 2 years post primary TKA (odds ratio [95% confidence interval], 25-29.9, 1.02[0.75-1.39], P = .90; 30-34.9, 0.93 [0.65-1.34], P = .71; 35-39.9, 1.16 [0.77-1.74], P = .47; ≥ 40,1.09 [0.69-1.73], [all P values ≥ .47]). Similarly, BMI was not associated with moderate-severe pain at 5-year primary TKA and at 2-year and 5-year revision TKA follow-up. Lack of association of higher BMI with poor pain outcomes post-TKA implies that TKA should not be denied to obese patients for fear of suboptimal outcomes.