Therefore, it is still not clear whether simultaneous bilateral TKA should be offered to obese patients having bilateral Osteoarthritis (OA) knee or simultaneous bilateral TKA in obese patients will have more complications or poorer outcomes as compared to non-obese patients. Furthermore, none of the studies specifically has evaluated the outcomes of simultaneous bilateral TKA in obese patients as compared to non-obese patients. A vast majority of the studies that are published in western literature are retrospective, and there is a scarcity of literature comparing the final outcomes of TKA in obese and non-obese patients, managed with the same protocol as in the Indian population. There have been many studies published on the outcome of TKA in obese patients, but still, it is inconclusive whether TKA has similar results in obese patients in terms of clinical outcome in comparison to non-obese patients. Studies conducted in the past reveal that obesity has an adverse effect on the final clinical outcome of obese patients undergoing TKA, such as delayed wound healing, higher medical complications, higher infection rates, poor post-operative functional out comes, and, ultimately, delayed recovery. Total knee arthroplasty in obese patients has its challenges starting from associated co-morbidities, to difficulties faced during surgery, such as positioning, exposure, increased chances of intraoperative bleeding, avulsion of the medial collateral ligament, and delayed recovery. Numerous studies have shown a correlation between elevated BMI resulting in articular cartilage loading forces, which may eventually cause tissue damage and early joint degeneration in the obese population. The WHO, defines obesity as BMI of above 30 kg/m 2. In the modern era, TKA as a surgery is being performed very commonly in the obese population. It has been offered to obese patients who were considered a relative contraindication a few years ago. Over the past two decades, total knee arthroplasty (TKA) has proved to be an effective solution for chronic knee pain arising due to arthritis. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Conclusion: We conclude in our study that simultaneous bilateral TKA gives comparable mid-term results in obese patients in comparison to the non-obese patients. There was no implant loosening or radiolucency seen. There was no statistically significant difference seen in the complication rate in both the groups. Oxford knee score was significantly better in non-obese group at 6 weeks, but was similar in both the groups at 3 months, 6 months, 1 year, and last follow-up. Post-operative hemoglobin drop, ICU requirement, length of hospital stay, mean walking time, and mean time to climbing stairs were similar in both the groups. Both the groups were matched with control in terms of pre-operative parameters. Results: Mean follow-up in obese group was 18 months (12–25 months) and in non-obese group was 17 months (12–24 months). Post-operative complications and time to recovery was also compared. Patients were followed up regularly and functional outcomes in terms of Oxford knee score were noted at 6 weeks, 3 months, and 1 year. All the patients underwent simultaneous bilateral TKA by a single surgeon using the same implant and technique. Patients with a BMI of less than 30 were classified as non-obese and those with a BMI of more than 30 were classified as obese. Materials and methods: We divided the patients into two study groups based on their body mass index (BMI). We conducted this study to evaluate the functional outcomes and complication rates of simultaneous bilateral TKA in obese patients matched control with non-obese patients. However, there is scarcity of literature comparing the functional outcomes of simultaneous bilateral TKA in obese patients with non-obese Indian population. * Corresponding author: Total Knee Arthroplasty (TKA) for decades has been an effective treatment modality for chronic arthritis of the knee. Junior Consultant, Department of Orthopedics, P.D Hinduja Hospital and Medical Research Centre, Mumbai, India Sanjay Agarwala 1 *, Yash Santosh Wagh 2 and Mayank Vijayvargiya 3Ĭhief of Orthopaedics and Director Professional Services, P.D Hinduja Hospital and Medical Research Centre, Mumbai, IndiaĬlinical Assistant, P.D Hinduja Hospital and Medical Research Centre, Mumbai, India
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