Department of Orthopedics and Traumatology, Fatih State Hospital, Trabzon, 61100, Turkey.
Department Of Orthopedics and Traumatology, University of Health Sciences, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey.
Arch Orthop Trauma Surg. 2024 May;144(5):2317-2326. doi: 10.1007/s00402-024-05335-0. Epub 2024 Apr 20.
The aim of this study was to compare the results of cementless bilateral total knee arthroplasty (TKA) between individuals in different obesity groups.
This was a retrospective cohort study. Patients with a body mass index (BMI) greater than 25 who underwent bilateral TKA for gonarthrosis between 2014 and 2020 and completed a minimum follow-up of 24 months were included. Age, sex, height, weight, BMI, operation time, length of stay, patient satisfaction, knee scores and complications were compared. Patients with missing data, who were followed for less than 24 months or had postoperative fractures around the knee were excluded.
There was a significant difference between the groups in terms of operation time (Class III > overweight > Class II > Class I p < 0.001). There was a significant difference in complications between the groups (Class III > Class I > Class II > overweight p = 0.010). According to our pairwise comparison, complications were more common in the class III group than in the overweight group. Knee score (KS) and function score (FS) increased significantly after surgery in all groups (p < 0.001), with no difference in FS (p = 0.448). Knee score changes were greater in the overweight and class I groups (p < 0.001). There was a significant interaction between both KS and FS and person satisfaction (p < 0.001).
Cementless TKA improved KS and FS in all obesity groups, yielded high patient satisfaction. Although the incidence of complications was higher in the morbidly obese patients than in the overweight patients, the difference was not significant. Patients with morbid obesity should be informed about related risks before planning cementless TKA.
本研究旨在比较不同肥胖组患者行非骨水泥双侧全膝关节置换术（TKA）的结果。
这是一项回顾性队列研究。纳入 2014 年至 2020 年期间因膝关节骨关节炎行双侧 TKA 且 BMI 大于 25、随访时间至少 24 个月的患者。比较患者的年龄、性别、身高、体重、BMI、手术时间、住院时间、患者满意度、膝关节评分和并发症。排除失访或随访时间不足 24 个月、膝周术后骨折的患者。
在手术时间方面，各组之间存在显著差异（III 级肥胖>超重>II 级肥胖>I 级肥胖，p<0.001）。各组之间并发症存在显著差异（III 级肥胖> I 级肥胖> II 级肥胖>超重，p=0.010）。根据我们的两两比较，III 级肥胖组的并发症发生率高于超重组。所有组的膝关节评分（KS）和功能评分（FS）在手术后均显著增加（p<0.001），但 FS 无差异（p=0.448）。超重组和 I 级肥胖组的 KS 变化更大（p<0.001）。KS 和 FS 与患者满意度之间存在显著交互作用（p<0.001）。
非骨水泥 TKA 可改善所有肥胖组的 KS 和 FS，患者满意度高。尽管病态肥胖患者的并发症发生率高于超重患者，但差异无统计学意义。在计划行非骨水泥 TKA 前，应向病态肥胖患者告知相关风险。
