Is There a Difference in PROMs Between Morbidly Obese Patients and Nonobese Patients Following Primary Total Knee Arthroplasty?

BACKGROUND

Patient satisfaction and patient-reported outcome measures (PROMs) are important for patients, surgeons, and payers in the current healthcare climate. Morbidly obese patients (body mass index [BMI] >40) have demonstrated higher incidence of complications after total knee arthroplasty (TKA) and can have difficulty obtaining access for their surgical care. The purpose of this study was to evaluate PROMs and patient satisfaction in morbidly obese patients undergoing primary TKA.

METHODS

A total of 75 patients with BMI >40 kg/m undergoing robotic-assisted TKA were retrospectively identified and matched 2:1 to a consecutive cohort of patients with BMI <35. The average BMI of the study cohort was 42.4 kg/m (39.5-51.3) compared to 28.6 kg/m (18.5-34.9) in the control group. Clinical outcomes, PROMs, and patient satisfaction were evaluated at a minimum 2-year follow-up.

RESULTS

The patients of the BMI >40 cohort were less likely to be discharged home ( = .0076), had less active flexion at 2 years ( = .0046), and had worse knee scores at 2 years (0.0497). Despite this, the percentage of patients who were satisfied or very satisfied after surgery was similar between the groups (87.5% vs 91.2%,  = .1943).

CONCLUSIONS

Morbidly obese patients are less likely to be discharged directly to home and may have functional differences after primary TKA. However, morbidly obese patients have similar PROMs and are as satisfied as nonobese patients at 2 years. Morbidly obese patients with end-stage knee osteoarthritis should also be able to enjoy the benefits of primary TKA following medical and surgical optimization.