Abstract
Objectives : Total knee arthroplasty (TKA) is one of the most commonly performed surgeries globally, particularly for patients with moderate-to-severe osteoarthritis. Predictors of postoperative outcomes have been thoroughly studied. Morbid obesity is one of the predictors that has shown controversy in the literature. A retrospective cohort chart review study was done to further explore the effect of morbid obesity on postoperative outcomes following TKA. Methods : After applying the inclusion/exclusion criteria, 507 patients were included and stratified based on the WHO body mass index classification. Demographic data was analyzed between 3 groups (non-obese, obese, and morbid obese), and post-operative complications were analyzed and compared between morbid obese and non-morbid obese. Results : In total, 14 (2.6%) patients required revision, with postoperative deep tissue infection being the most common reason. Postoperative deep tissue infection developed in 4 (4.3%) patients with morbid obesity and in 2 (0.05%) without, which was a statistically significant difference (P = 0.012). Furthermore, 5 (5.4%) patients with morbid obesity and 7 (1.7%) without required revision, which showed a statistically significant difference (P = 0.034). The overall need for red blood cells (RBC) transfusion due to postoperative anemia was recorded in 11 (11.9%) patients with morbid obesity and 100 (24.1%) without, which was a statistically significant difference (P = 0.008). Conclusion : Patients with morbid obesity are less likely to require RBC transfusion due to postoperative anemia but have a higher risk of developing postoperative deep tissue infection and undergoing revision for their prostheses when compared with those without morbid obesity.