Common modifiable risk factors in total joint arthroplasty: a 2021 update—obesity
Part 1 | Diabetes
Part 3 | Smoking
This series of articles was created with the support of the following specialists (in alphabetical order):
Matthew P Abdel
Rochester, United States
University of Western Ontario
Michael A Mont
Rubin Institute for Advanced Orthopedics
Baltimore, United States
This article was compiled by Maio Chen, Senior Project Manager Medical Writing, AO Foundation, Switzerland.
- AAOS. Diagnosis and Prevention of Periprosthetic Joint Infections, Evidence-Based Clinical Practice Guideline2019 July 28, 2021.
- Lübbeke A, Zingg M, Vu D, et al. Body mass and weight thresholds for increased prosthetic joint infection rates after primary total joint arthroplasty. Acta Orthop. 2016;87(2):132–138.
- Issa K, Harwin SF, Malkani AL, et al. Bariatric Orthopaedics: Total Hip Arthroplasty in Super-Obese Patients (Those with a BMI of ≥50 kg/m2). J Bone Joint Surg Am. 2016 Feb 3;98(3):180–185.
- Wagner ER, Kamath AF, Fruth K, et al. Effect of Body Mass Index on Reoperation and Complications After Total Knee Arthroplasty. J Bone Joint Surg Am. 2016 Dec 21;98(24):2052–2060.
- George J, Piuzzi NS, Jawad MM, et al. Reliability of International Classification of Diseases, Ninth Edition, Codes to Detect Morbid Obesity in Patients Undergoing Total Hip Arthroplasty. J Arthroplasty. 2018 Sep;33(9):2770–2773.
- George J, Piuzzi NS, Ng M, et al. Association Between Body Mass Index and Thirty-Day Complications After Total Knee Arthroplasty. J Arthroplasty. 2018 Mar;33(3):865–871.
- Boyce L, Prasad A, Barrett M, et al. The outcomes of total knee arthroplasty in morbidly obese patients: a systematic review of the literature. Arch Orthop Trauma Surg. 2019 Apr;139(4):553–560.
- Adhikary SD, Liu WM, Memtsoudis SG, et al. Body Mass Index More Than 45 kg/m(2) as a Cutoff Point Is Associated With Dramatically Increased Postoperative Complications in Total Knee Arthroplasty and Total Hip Arthroplasty. J Arthroplasty. 2016 Apr;31(4):749–753.
- Kwasny MJ, Edelstein AI, Manning DW. Statistical Methods Dictate the Estimated Impact of Body Mass Index on Major and Minor Complications After Total Joint Arthroplasty. Clinical orthopaedics and related research. 2018;476(12):2418–2429.
- Roth A, Anis HK, Emara AK, et al. The Potential Effects of Imposing a Body Mass Index Threshold on Patient-Reported Outcomes After Total Knee Arthroplasty. J Arthroplasty. 2021 Jul;36(7s):S198–s208.
- Giori NJ, Amanatullah DF, Gupta S, et al. Risk Reduction Compared with Access to Care: Quantifying the Trade-Off of Enforcing a Body Mass Index Eligibility Criterion for Joint Replacement. J Bone Joint Surg Am. 2018 Apr 4;100(7):539–545.
- Statz JM, Odum SM, Johnson NR, et al. Failure to Medically Optimize Before Total Hip Arthroplasty: Which Modifiable Risk Factor Is the Most Dangerous? Arthroplast Today. 2021 Aug;10:18–23.
- Haverkamp D, Klinkenbijl MN, Somford MP, et al. Obesity in total hip arthroplasty--does it really matter? A meta-analysis. Acta Orthop. 2011 Aug;82(4):417–422.
- Kerkhoffs GM, Servien E, Dunn W, et al. The influence of obesity on the complication rate and outcome of total knee arthroplasty: a meta-analysis and systematic literature review. J Bone Joint Surg Am. 2012 Oct 17;94(20):1839–1844.
- Issa K, Pivec R, Kapadia BH, et al. Does obesity affect the outcomes of primary total knee arthroplasty? J Knee Surg. 2013 Apr;26(2):89–94.
- Roth A, Khlopas A, George J, et al. The Effect of Body Mass Index on 30-day Complications After Revision Total Hip and Knee Arthroplasty. J Arthroplasty. 2019 Jul;34(7s):S242–s248.
- Giesinger K, Giesinger JM, Hamilton DF, et al. Higher body mass index is associated with larger postoperative improvement in patient-reported outcomes following total knee arthroplasty. BMC Musculoskelet Disord. 2021 Jul 24;22(1):635.
- Baker P, Petheram T, Jameson S, et al. The association between body mass index and the outcomes of total knee arthroplasty. J Bone Joint Surg Am. 2012 Aug 15;94(16):1501–1508.
- Lash H, Hooper G, Hooper N, et al. Should a Patients BMI Status be Used to Restrict Access to Total Hip and Knee Arthroplasty? Functional Outcomes of Arthroplasty Relative to BMI - Single Centre Retrospective Review. Open Orthop J. 2013;7:594–599.
- Elkins JM, Simoens KJ, Callaghan JJ. Lower Extremity Geometry in Morbid Obesity-Considerations for Total Knee Arthroplasty. J Arthroplasty. 2018 Oct;33(10):3304–3312.
- Armstrong JG, Morris TR, Sebro R, et al. Prospective Study of Central versus Peripheral Obesity in Total Knee Arthroplasty. Knee Surg Relat Res. 2018 Dec 1;30(4):319–325.