Answer letter concerning “Long-term outcome of total knee arthroplasty in patients with morbid obesity”

  • Jeries Hakim
  • Gershon VolpinEmail author
  • Mahmud Amashah
  • Faris Alkeesh
  • Saker Khamaisy
  • Miri Cohen
  • Jamal Ownallah
Letter to the Editor

Dear Editor,

We want to thank very much Prof. Chao Tu and his co-authors for their kind and supportive evaluation and important remarks for our paper “Long-term outcome of total knee arthroplasty in patients with morbid obesity” (INOR-D-01523).

Regarding their questions:
  1. 1.

    We presented the early and late complications in Table 3. The figures of number of complications are too small to make interpretations from statistical tests; therefore, the p value for the overall number of complications was conducted. However, chi-square analysis with Yates’ correction shows that the differences between the groups for each of the symptoms were not statistically significant (p > .05).

  2. 2.

    We agree with the remark regarding the possible effects of female ratio and knee deformity, ASA grade, and chronic pulmonary problems in the morbidly obese group. In our opinion, it is also very important to operate only well-balanced patients with diabetes mellitus, hypertension, and other medical conditions, as emphasized in the paper [1]. However, in this retrospective series, there were only 1/162 TKRs with transient peroneal nerve palsy in the morbidly obese group, 4/162 TKRs with superficial infection vs 3/212 TKRs in the non-obese and obese groups, and only 1/162 TKRs with skin necrosis in the morbidly obese patients.

  3. 3.

    Thanks for these remarks—there were 127 morbidly obese patients and the 162 TKRs were performed in 27 males and 135 females.


Many thanks again,

Gershon Volpin



  1. 1.
    Hakim J, Volpin G, Amashah M, Alkeesh F, Khamaisy S, Cohen M, Ownallah J. (2019) Long-term outcome of total knee arthroplasty in patients with morbid obesity. Int Orthop. 2019 Aug 2.

Copyright information

© SICOT aisbl 2019

Authors and Affiliations

  1. 1.Department of Orthopedic Surgery, EMMS Hospital, Nazareth, Affiliated to Galilee Medical Faculty ZfatBar Ilan UniversityRamat GanIsrael
  2. 2.Faculty of Social Welfare and Health Science and the Center for Rehabilitation ResearchUniversity of HaifaHaifaIsrael

Personalised recommendations