The Impact of Morbid Obesity on Patient Outcomes After Total Knee Arthroplasty

2008 ◽  
Vol 23 (6) ◽  
pp. 795-800 ◽  
Author(s):  
Vaishnav Rajgopal ◽  
Robert B. Bourne ◽  
Bert M. Chesworth ◽  
Steven J. MacDonald ◽  
Richard W. McCalden ◽  
...  
Keyword(s):  
Morbid Obesity ◽  
Total Knee Arthroplasty ◽  
Patient Outcomes ◽  
Knee Arthroplasty ◽  
Total Knee ◽  
The Impact

The Impact of Diabetes on Perioperative Patient Outcomes after Total Hip and Total Knee Arthroplasty in the United States

2008 ◽  
Vol 23 (2) ◽  
pp. 322-323
Author(s):  
Michael P. Bolognesi ◽  
Milford H. Marchant, Jr. ◽  
Nicholas A. Viens ◽  
Chad Cook ◽  
Ricardo Pietrobon ◽  
...  
Keyword(s):  
United States ◽  
Total Knee Arthroplasty ◽  
Patient Outcomes ◽  
Knee Arthroplasty ◽  
The United States ◽  
Total Hip ◽  
Total Knee ◽  
The Impact

The Impact of Diabetes on Perioperative Patient Outcomes After Total Hip and Total Knee Arthroplasty in the United States

2008 ◽  
Vol 23 (6) ◽  
pp. 92-98 ◽  
Author(s):  
Michael P. Bolognesi ◽  
Milford H. Marchant ◽  
Nicholas A. Viens ◽  
Chad Cook ◽  
Ricardo Pietrobon ◽  
...  
Keyword(s):  
United States ◽  
Total Knee Arthroplasty ◽  
Patient Outcomes ◽  
Knee Arthroplasty ◽  
The United States ◽  
Total Hip ◽  
Total Knee ◽  
The Impact

Is ICD-9 Coding of Morbid Obesity Reliable in Patients Undergoing Total Knee Arthroplasty?

2018 ◽  
Vol 31 (10) ◽  
pp. 934-939 ◽  
Author(s):  
Jaiben George ◽  
Nipun Sodhi ◽  
Hiba Anis ◽  
Anton Khlopas ◽  
Joseph Moskal ◽  
...  
Keyword(s):  
Morbid Obesity ◽  
Total Knee Arthroplasty ◽  
Sensitivity And Specificity ◽  
Knee Arthroplasty ◽  
International Classification Of Diseases ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Primary Tkas ◽  
Total Knee ◽  
The Impact

AbstractMorbid obesity is considered to have a stronger association with complications after total knee arthroplasty (TKA). Although the impact of obesity coding errors has been previously reported, the extent of coding inaccuracies with respect to morbid obesity is unclear. Therefore, the purpose of this study was to assess (1) the utility of coding in identifying morbid obesity and (2) the effects of morbid obesity on 90-day complications after TKA when morbid obesity was defined by both body mass index (BMI) and International Classification of Diseases 9th edition (ICD-9) coding. A total of 18,030 primary TKAs performed at a single institution from 2004 to 2014 were identified. Patients were defined as morbidly obese based on ICD-9 codes or by BMI recorded in the electronic medical record (EMR). Patients were defined as obese (ICD-9 codes 278.0, 278.00, 278.01, 278.03, 649.10–14, 793.91, V85.30–39, V85.41–45, V85.54) or morbidly obese (278.01, V85.41–45) by ICD-9 codes. Patient EMRs were also reviewed to identify obese and morbidly obese patients (BMI cutoffs of 30 and 40 kg/m2, respectively). Complications between the cohorts were compared. Sensitivity and specificity were also calculated. Among the 2,880 surgeries performed in morbidly obese patients, a code for obesity was present in 1,618 (56.2%) surgeries, but only 57.9% (937) of these patients had a code specific for morbid obesity, with the rest having a code not specifying morbid obesity. The sensitivity and specificity of obesity coding were 34.5 and 96.0%, while that of morbid obesity were 32.5 and 96.7%, respectively (area under curve: 0.65 vs. 0.65, p = 0.214). A higher rate of complications was noted when patients were defined as morbidly obese by ICD-9 as when defined by EMR-reported BMI. Although morbidly obese patients are more likely to have a code for obesity compared with obese patients, these patients may not be correctly identified as morbidly obese due to a lack of specificity in the codes. These errors may lead to inadequate reimbursements, and may also overestimate the effect of morbid obesity on complications.

The Impact of Diabetes on Patient Outcomes After Total Knee Arthroplasty in an Asian Population

2018 ◽  
Vol 33 (10) ◽  
pp. 3186-3189 ◽  
Author(s):  
Bryon J.X. Teo ◽  
Hwei-Chi Chong ◽  
William Yeo ◽  
Andrew H.C. Tan
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Outcomes ◽  
Knee Arthroplasty ◽  
Asian Population ◽  
Total Knee ◽  
The Impact

scholarly journals Higher body mass index is associated with larger postoperative improvement in patient-reported outcomes following total knee arthroplasty

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
K Giesinger ◽  
JM Giesinger ◽  
DF Hamilton ◽  
J Rechsteiner ◽  
A Ladurner
Keyword(s):  
Body Mass Index ◽  
Total Knee Arthroplasty ◽  
Pain Relief ◽  
Body Mass ◽  
Knee Arthroplasty ◽  
Normal Weight ◽  
World Health ◽  
Obese Patients ◽  
Total Knee ◽  
The Impact

Abstract Background Total knee arthroplasty is known to successfully alleviate pain and improve function in endstage knee osteoarthritis. However, there is some controversy with regard to the influence of obesity on clinical benefits after TKA. The aim of this study was to investigate the impact of body mass index (BMI) on improvement in pain, function and general health status following total knee arthroplasty (TKA). Methods A single-centre retrospective analysis of primary TKAs performed between 2006 and 2016 was performed. Data were collected preoperatively and 12-month postoperatively using WOMAC score and EQ-5D. Longitudinal score change was compared across the BMI categories identified by the World Health Organization. Results Data from 1565 patients [mean age 69.1, 62.2% women] were accessed. Weight distribution was: 21.2% BMI < 25.0 kg/m2, 36.9% BMI 25.0–29.9 kg/m2, 27.0% BMI 30.0–34.9 kg/m2, 10.2% BMI 35.0–39.9 kg/m2, and 4.6% BMI ≥ 40.0 kg/m2. All outcome measures improved between preoperative and 12-month follow-up (p < 0.001). In pairwise comparisons against normal weight patients, patients with class I-II obesity showed larger improvement on the WOMAC function and total score. For WOMAC pain improvements were larger for all three obesity classes. Conclusions Post-operative improvement in joint-specific outcomes was larger in obese patients compared to normal weight patients. These findings suggest that obese patients may have the greatest benefits from TKA with regard to function and pain relief one year post-op. Well balanced treatment decisions should fully account for both: Higher benefits in terms of pain relief and function as well as increased potential risks and complications. Trial registration This trial has been registered with the ethics committee of Eastern Switzerland (EKOS; Project-ID: EKOS 2020–00,879)

The Impact of Gastric Bypass Surgery Compared to Total Knee Arthroplasty on Knee Symptoms

2018 ◽  
Vol 04 (02) ◽  
Author(s):  
Hafiz Kassam ◽  
Allan Okrainec ◽  
Timothy Jackson ◽  
Michael G Zyweil ◽  
Anthony V Perruccio ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Gastric Bypass ◽  
Knee Arthroplasty ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Total Knee ◽  
The Impact

Bone ingrowth in total knee arthroplasty: The impact of HA-coatings and the relation with mechanical stability

1998 ◽  
Vol 31 ◽  
pp. 26
Author(s):  
L. Labey ◽  
H. Van Campenhout ◽  
J. Vander Sloten ◽  
R. Van Audekercke ◽  
G. Van der Perre ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Mechanical Stability ◽  
Bone Ingrowth ◽  
Total Knee ◽  
The Impact

Effect of Gait on Patellofemoral Mechanics

2008 ◽  
Author(s):  
Jeffrey E. Bischoff ◽  
Justin S. Hertzler
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Clinical Studies ◽  
Patellofemoral Joint ◽  
Knee Kinematics ◽  
Component Design ◽  
Total Knee ◽  
The Impact ◽  
Reconstructed Knee

Computational modeling of the reconstructed knee is an important tool in designing components for maximum functionality and life. Utilization of boundary conditions consistent with in vivo gait loading in such models enables predictions of knee kinematics and polyethylene damage [1–4], which can then be used to optimize component design. Several recent clinical studies have focused on complications associated with the patellofemoral joint [5–6], highlighting the need to better understand the mechanics of this compartment of total knee arthroplasty (TKA). This study utilizes a computational model to characterize the impact of gait loading on the mechanics of the patella in TKA.

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