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The influence of obesity on achievement of a ‘forgotten joint’ following total knee arthroplasty

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Obesity has been associated with poorer outcomes following total knee arthroplasty (TKA); however, data remain sparse on its impact on patients’ joint awareness following surgery. This study aims to investigate the impact of body mass index (BMI) on improvement in outcomes following TKA as assessed by the Forgotten Joint Score-12 (FJS-12).

Materials and methods

We retrospectively reviewed 1075 patients who underwent primary TKA from 2017 to 2020 with available postoperative FJS-12 scores. Patients were stratified based on their BMI (kg/m2): < 30, 30.0–34.9 (obese class I), 35.0–39.9 (obese class II), and ≥ 40 (obese class III). FJS-12 and KOOS, JR scores were collected at various time points. Demographic differences were assessed with Chi-square and ANOVA tests. Mean scores between BMI groups were compared using univariate ANCOVA, controlling for observed demographic differences.

Results

Of the 1075 patients included, there were 457 with a BMI < 30, 331 who were obese class I, 162 obese class II, and 125 obese class III. There were no statistical differences in FJS-12 scores between the BMI groups at 3 months (27.24 vs. 25.33 vs. 23.57 vs. 22.48; p = 0.99), 1 year (45.07 vs. 41.86 vs. 40.51 vs. 36.22; p = 0.92) and 2 years (51.31 vs. 52.86 vs. 46.17 vs. 44.97; p = 0.94). Preoperative KOOS, JR scores significantly differed between the various BMI categories (49.33 vs. 46.63 vs. 44.24 vs. 39.33; p < 0.01); however, 3-month (p = 0.20) and 1-year (p = 0.13) scores were not statistically significant. Mean improvement in FJS-12 scores from 3 months to 2 years was statistically greatest for obese class I patients and lowest for obese class III patients (24.07 vs. 27.53 vs. 22.60 vs. 22.49; p = 0.01). KOOS, JR score improvement from baseline to 1 year was statistically greatest for obese class III patients and lowest for non-obese patients (22.34 vs. 25.49 vs. 23.77 vs. 27.58; p < 0.01).

Conclusion

While all groups demonstrated postoperative improvement, those with higher BMI reported lower mean FJS-12 scores but these differences were not found to be significant. Our study showed no significant impact of BMI on postoperative joint awareness, which implies that obese patients, in all obesity classes, experience similar functional improvement following TKA.

Level III Evidence

Retrospective Cohort Study.

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Funding

In addition, there was no funding provided for this study. The records and existing data were de-identified and a part of our institutional quality improvement program; therefore, the present study was exempt from human-subjects review by our Institutional Review Board (IRB).

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Authors and Affiliations

  1. Department of Orthopedic Surgery, NYU Langone Health, 301 East 17th Street, New York, NY, 10003, USA

    Vivek Singh, David Yeroushalmi, Katherine A. Lygrisse, William J. Long & Ran Schwarzkopf

  2. Department of Orthopedic Surgery, NYU Langone Hospital Long Island, 259 1st St, Mineola, NY, 11501, USA

    Trevor Simcox

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  1. Vivek Singh
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  2. David Yeroushalmi
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  3. Katherine A. Lygrisse
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Correspondence to Ran Schwarzkopf.

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Singh, V., Yeroushalmi, D., Lygrisse, K.A. et al. The influence of obesity on achievement of a ‘forgotten joint’ following total knee arthroplasty. Arch Orthop Trauma Surg 142, 491–499 (2022). https://doi.org/10.1007/s00402-021-03840-0

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