The Effect of Body Mass Index on 30-day Complications After Revision Total Hip and Knee Arthroplasty

Mar 9, 2019The Journal of arthroplasty

Body Mass Index and 30-Day Complications After Hip and Knee Replacement Surgery

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Abstract

A total of 18,866 patients were analyzed for complications following knee and hip surgeries.

Readmission and reoperation rates increased with higher BMI for revision total knee arthroplasty (rTKA).
A linear relationship was observed between BMI and readmission rates for rTKA.
Morbid obesity was associated with a higher reoperation rate for revision total hip arthroplasty (rTHA) in univariate analysis.
Multivariate analysis did not show a significant increase in readmission or reoperation rates for rTHA with increasing BMI.
The lowest rates of complications occurred around a BMI of 30 kg/m.

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BACKGROUND: We aimed to explore the effect of body mass index (BMI) on 30-day complications after aseptic revision total knee arthroplasty (rTKA) and aseptic revision total hip arthroplasty (rTHA), considering BMI as both a categorical and continuous variable.

METHODS: A total of 18,866 patients (9093 rTHA and 9773 rTKA) patients were included for analysis using the American College of Surgeons National Surgical Quality Improvement Project database. Thirty-day rates of readmissions, reoperations, and major and minor complications were compared between different weight categories (overweight: BMI >25 and ≤30 kg/m; obese: BMI >30 and ≤40 kg/m; morbidly obese: BMI >40 kg/m) and the normal weight category (BMI >18.5 and ≤25 kg/m) using multivariate regression models. Spline regression models were created to study BMI as a continuous variable. 2 2 2 2

RESULTS: Both readmission rates and reoperation rates increased for rTKA as BMI increased (P < .005). There was a linear relationship between BMI and readmission rates for rTKA. Morbid obesity was associated with an increased reoperation rate for rTHA on univariate analysis (P = .022); however, multivariate analysis showed no statistically significant increase in readmission or reoperation rates as BMI increased for rTHA.

CONCLUSIONS: The relationship between BMI and complications after revision total joint arthroplasty is a J-shaped curve with the lowest rates of complications occurring around a BMI of 30 kg/m. The relationship between BMI and perioperative complications is stronger for revision TKA as opposed to revision THA. 2

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The Effect of Body Mass Index on 30-day Complications After Revision Total Hip and Knee Arthroplasty

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