Sajid Khan Mohammad Adeel, Ali Mohammed A, Atieh Fatima M, Ali Shayma M, El-Hagrasy Ahmed M, Khan Hammad N, Javaid Butt Ahsan
Orthopedic Surgery, King Hamad University Hospital, Manama, BHR.
Medicine, School of Medicine, Royal College of Surgeons in Ireland, Muharraq, BHR.
Cureus. 2025 May 12;17(5):e83968. doi: 10.7759/cureus.83968. eCollection 2025 May.
Total knee arthroplasty (TKA) effectively relieves pain and improves functional capacity in end-stage knee osteoarthritis (OA). However, the influence of obesity, particularly as measured by body mass index (BMI), on TKA outcomes remains a subject of debate. This study aimed to investigate the relationship between BMI, knee subcutaneous fat measurements, and postoperative functional outcomes following TKA.
A retrospective analysis was conducted that included 100 patients (31 men and 69 women) who underwent primary TKA at a single university hospital. Patients were categorized based on BMI (kg/m) into three groups: control (BMI <30), obese (BMI 30-39.9), and morbidly obese (BMI ≥40). Data collection included measurements of BMI, radiological fat indices, and assessment of joint function recovery using the 12-item Forgotten Joint Score (FJS-12) and flexion scores. Statistical analysis was performed to evaluate correlations and differences between BMI groups.
The majority of patients were women (69%), with no significant BMI difference between genders. The surgical indication was predominantly OA, with a higher frequency seen in groups with BMI ≥30. Patients with a higher BMI underwent TKA at a younger age (p<0.00001). There was no significant difference in postoperative FJS-12 and flexion scores among BMI groups. Correlation analysis showed weak positive correlations between BMI/subcutaneous fat indices and functional outcomes. In addition, complication rates were low, with no reported infections.
Obesity did not independently affect TKA outcomes, with equivalent results observed across BMI groups. However, a higher BMI correlated with younger age at TKA. BMI and knee subcutaneous fat indices showed a poor predictive value for postoperative functional recovery. This study underscores the increasing proportion of obese patients undergoing TKA and the need for further research to understand the complex relationship between obesity, subcutaneous fat distribution, and TKA outcomes.
全膝关节置换术（TKA）可有效缓解终末期膝关节骨关节炎（OA）的疼痛并改善功能。然而，肥胖对TKA结果的影响，尤其是通过体重指数（BMI）衡量的影响，仍是一个有争议的话题。本研究旨在调查BMI、膝关节皮下脂肪测量值与TKA术后功能结果之间的关系。
进行了一项回顾性分析，纳入了在一家大学医院接受初次TKA的100例患者（31例男性和69例女性）。患者根据BMI（kg/m）分为三组：对照组（BMI<30）、肥胖组（BMI 30-39.9）和病态肥胖组（BMI≥40）。数据收集包括BMI测量、放射学脂肪指数以及使用12项遗忘关节评分（FJS-12）和屈曲评分评估关节功能恢复情况。进行统计分析以评估BMI组之间的相关性和差异。
大多数患者为女性（69%），性别之间BMI无显著差异。手术指征主要为OA，在BMI≥30的组中更为常见。BMI较高的患者在较年轻的年龄接受TKA（p<0.00001）。BMI组之间术后FJS-12和屈曲评分无显著差异。相关性分析显示BMI/皮下脂肪指数与功能结果之间存在弱正相关。此外，并发症发生率较低，未报告感染情况。
肥胖并未独立影响TKA结果，各BMI组的结果相当。然而，较高的BMI与TKA时较年轻的年龄相关。BMI和膝关节皮下脂肪指数对术后功能恢复的预测价值较差。本研究强调了接受TKA的肥胖患者比例不断增加，以及需要进一步研究以了解肥胖、皮下脂肪分布与TKA结果之间的复杂关系。
