ReviewHSS journal : the musculoskeletal journal of Hospital for Special Surgery2014
The Influence of Obesity on the Outcome of TKR: Can the Impact of Obesity be justified from the Viewpoint of the Overall Health Care System?
Review in HSS journal : the musculoskeletal journal of Hospital for Special Surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Acquired Idiopathic Stiffness After Total Knee Arthroplasty: A Systematic Review and Meta-Analysis.The Journal of bone and joint surgery. American volume · 2019Pooled it
- Measurement of periarticular subcutaneous fat on CT images and adverse outcomes following total knee arthroplasty.Journal of orthopaedics · 2025Article
- The Etiology of Total Knee Arthroplasty Failure Influences on Improvement in Knee Function: A Follow-Up Study.Journal of clinical medicine · 2024Article
- In Vivo Assessment of a Triple Periodic Minimal Surface Based Biomimmetic Gyroid as an Implant Material in a Rabbit Tibia Model.ACS materials Au · 2024Article
- Nutritionist Referral Modestly Improves Weight Loss and Increases Surgery Rate in Obese Patients Seeking Total Joint Arthroplasty.Arthroplasty today · 2022Article
- Operative Techniques to Reduce Hip and Knee Arthroplasty Complications in Morbidly Obese Patients.Arthroplasty today · 2022Article
- Prediction of Pain and Opioid Utilization in the Perioperative Period in Patients Undergoing Primary Knee Arthroplasty: Psychophysical and Psychosocial Factors.Pain medicine (Malden, Mass.) · 2019Article
- Association between preoperative anaemia and blood transfusion with long-term functional and quality of life outcomes amongst patients undergoing primary total knee arthroplasty in Singapore: a single-centre retrospective study.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2019Article
- Management of symptomatic knee osteoarthritis in obesity: a survey of orthopaedic surgeons' opinions and practice.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2018Article
- Evaluation of the Multi-Attribute Prioritisation Tool for Total Joint Replacement.Journal of orthopaedics · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is controversy in the literature regarding the justification of performing total knee replacement (TKR) in obese patients in view of their increased risk of poor outcomes and how those poorer outcomes impact the health care system overall. QUESTIONS/PURPOSES: Is TKR justifiable in the obese patient? Can the negative impact of continuing to perform TKR in the obese be quantified?
methodsA Cochrane Library, PubMed (MEDLINE), and Google Scholar search related to the justification of TKR in the obese patient and its impact on the health care system was analyzed. The main criteria for selection were that the articles were focused in the aforementioned questions.
resultsTwo thousand one hundred seventy-three articles were found, but only 50 were selected and reviewed because they were focused on the questions of this paper. Although some articles (with low grade of evidence) did not find that obesity adversely affected the outcome of TKR, most of them found that obesity adversely affected the results of TKR. Regarding complications rates and survival rates, obesity has shown to have a negative influence on outcome after TKR. The improvements in patient-reported outcome measures, however, were similar irrespective of body mass index. Regarding the impact of TKR in obese patients, an extra cost of US$3,050 has been reported per patient. Considering that 50% of the US population is obese and that 600,000 TKRs are implanted per year, the impact for the US health system could be as much as 915 million dollars (300,000 × 3,050).
conclusionTKR in obese patients may be justifiable because the functional improvements appear equivalent to those of patients with a lower BMI. However, in obese patients, the risk of complications is higher and the prosthetic survival is lower. Moreover, TKR in obese patients has a huge impact on the health system which should be considered.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.