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Morbid Obesity and Total Knee Arthroplasty: A Growing Problem

Martin, J. Ryan MD; Jennings, Jason M. MD, DPT; Dennis, Douglas A. MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: March 2017 - Volume 25 - Issue 3 - p 188–194
doi: 10.5435/JAAOS-D-15-00684
Review Article

Obesity is an epidemic, with approximately 35% of the US population affected. This rate is unlikely to decline and may increase the demand for total knee arthroplasty (TKA). Data regarding the risks, benefits, and potential complications of TKA in this patient population are conflicting. Preoperative considerations are optimization of nutritional status, safe weight loss strategies, and bariatric surgery. Intraoperative concerns unique to this population include inadequate exposure, implant alignment, and durable implant fixation; postoperative issues include tibial loosening, wound complications, cardiovascular events, and respiratory complications. A thorough understanding of the medical and surgical complications associated with TKA in the obese patient will facilitate research efforts and improve outcomes.

From OrthoCarolina, Charlotte, NC (Dr. Martin), Colorado Joint Replacement, Denver, CO (Dr. Jennings and Dr. Dennis), and the Department of Bioengineering, University of Denver, Denver, the Department of Orthopaedics, University of Colorado School of Medicine, Aurora, CO, and the University of Tennessee, Knoxville, TN (Dr. Dennis).

Dr. Martin or an immediate family member serves as a paid consultant to Zimmer Biomet. Dr. Jennings or an immediate family member serves as a paid consultant to DePuy Synthes and Total Joint Orthopedics and has received research or institutional support from DePuy Synthes and Porter Adventist Hospital. Dr. Dennis or an immediate family member has received royalties from DePuy Synthes and Innomed; is a member of a speakers’ bureau or has made paid presentations on behalf of and serves as a paid consultant to DePuy Synthes; has stock or stock options held in Joint Vue; and has received research or institutional support from DePuy Synthes and Porter Adventist Hospital.

Received November 29, 2015

Accepted April 09, 2016

© 2017 by American Academy of Orthopaedic Surgeons
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