Is Obesity a Contraindication for Minimal Invasive Total Knee Replacement? A Prospective Randomized Control Trial

Background Although total knee replacement (TKR) has been proven a very successful treatment modality for the end-stage knee osteoarthritis (OA) in obese patients, the rehabilitation period often is long and painful. Minimal invasive surgery (MIS) has gained much attention in TKR promising fast and...

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Bibliographic Details
Published in:Obesity surgery 2010-12, Vol.20 (12), p.1633-1641
Main Authors: Chalidis, Byron E., Petsatodis, George, Christodoulou, Anastasios G., Christoforidis, John, Papadopoulos, Pericles P., Pournaras, John
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Arthralgia - diagnostic imaging
Arthralgia - surgery
Arthroplasty, Replacement, Knee
Body Mass Index
Clinical outcomes
Clinical Research
Clinical trials
Contraindications
Female
Humans
Joint replacement surgery
Knee
Knee Prosthesis
Male
Medicine
Medicine & Public Health
Middle Aged
Minimally Invasive Surgical Procedures
Obesity
Pain Measurement
Prospective Studies
Radiography
Range of Motion, Articular
Surgery
Surgical techniques
Treatment Outcome
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Summary:Background Although total knee replacement (TKR) has been proven a very successful treatment modality for the end-stage knee osteoarthritis (OA) in obese patients, the rehabilitation period often is long and painful. Minimal invasive surgery (MIS) has gained much attention in TKR promising fast and less painful recovery. However, little is known about the effectiveness of the technique in the obese adult population. Methods One hundred consecutive patients with body mass index (BMI) > 30 kg/m 2 and tricompartmental knee OA were randomly assigned to undergo either standard TKR (50 patients) or MIS-TKR (50 patients). The patients were assessed clinically and radiologically before the procedure and at subsequent postoperative follow-up visits, until 2 years after the operation. Results Knee society function and pain scores were significantly higher in MIS group for 3 months following surgery. Patients after MIS had also lower levels of pain during hospitalization. Tourniquet time was on average 7 min longer during MIS-TKR ( p  = 0.03) but operative time was almost equal in both groups ( p  = 0.11). No statistical significant difference was found between groups regarding the amount of blood loss ( p  = 0.49) or incidence of allogeneic blood transfusion ( p  = 0.27). Active straight leg raising was achieved 2.2 days earlier, on average, after MIS-TKR ( p  
ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-009-9968-6