Impact of body mass index on robotic-assisted total knee arthroplasty outcomes: A retrospective cohort analysis

IF 3.3 Q1 ORTHOPEDICS

Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine Pub Date : 2025-07-17 DOI:10.1016/j.jisako.2025.100927

Waldo Gonzalez Duque , Rafael Calvo Rodriguez , David Figueroa Poblete , Jorge Isla Villanueva , Daniela Landea Caroca , Camila Tapia Castillo

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引用次数: 0

Abstract

Introduction

Obesity is a growing global health concern and a known risk factor in total knee arthroplasty (TKA). With an increasing number of obese patients requiring TKA, it is essential to understand how obesity influences clinical outcomes and complication rates. The objective of this study is to investigate the impact of obesity on clinical outcomes and complications in patients undergoing robotic-assisted TKA (RA-TKA).

Methods

A retrospective cohort study was conducted on 216 patients aged ≥18 years who underwent RA-TKA between 2019 and 2023, with a minimum postoperative follow-up of one year. Patients were stratified into three body mass index (BMI) categories: <25, 25–29, and ≥30 kg/m². Demographic, intraoperative, and postoperative variables—including tourniquet use and time, implant type, hospital stay, and complications—were compared. Statistical analysis was performed (p < 0.05).

Results

Two hundred sixteen patients (91.5% follow-up rate) were evaluated at a mean of 34 months, postoperatively. No statistically significantly difference was found among the BMI groups in terms of age, sex, use of tourniquet, hospital stay, or use of stem implants. A statistically significant difference was observed only in the group of BMI <25 kg/m² regarding arthrofibrosis. When patients were grouped as a BMI <35 vs a BMI ≥ 35 kg/m², a higher complication rate was noted in the ≥35 kg/m² group (18.2% versus 7.2%), though the difference was not statistically significant (p = 0.09).

Conclusions

This study found that the difference was not statistically significant in the overall rate of postoperative complications among patients with obesity undergoing RA-TKA. However, a nonsignificant trend toward a higher complication rate was observed in patients with severe obesity (BMI ≥35 kg/m²). Interestingly, a statistically significant increase in arthrofibrosis was found in patients with BMI <25 kg/m², a finding that contrasts with the current literature.

Level of Evidence

Level III.

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体重指数对机器人辅助全膝关节置换术结果的影响：一项回顾性队列分析。

肥胖是一个日益增长的全球健康问题，也是全膝关节置换术（TKA）的已知危险因素。随着越来越多的肥胖患者需要TKA，了解肥胖如何影响临床结果和并发症发生率是至关重要的。本研究的目的是探讨肥胖对机器人辅助TKA （RA-TKA）患者临床结局和并发症的影响。方法：对2019 - 2023年间接受RA-TKA治疗的216例年龄≥18岁的患者进行回顾性队列研究，术后随访时间最少1年。将患者分为体重指数(BMI) < 25、25-29和≥30 kg/m2三类。比较了人口统计学、术中和术后变量，包括止血带的使用和时间、植入物类型、住院时间和并发症。进行统计学分析（p值< 0.05）。结果：216例患者术后平均34个月随访，随访率91.5%。BMI组之间在年龄、性别、止血带使用、住院时间或使用干细胞植入物方面没有统计学上的显著差异。在关节纤维化方面，只有BMI < 25 kg/m2组存在统计学差异。当BMI < 35 vs≥35 kg/m2分组时，≥35 kg/m2组的并发症发生率更高（18.2% vs 7.2%），但差异无统计学意义（p= 0.09）。结论：本研究发现肥胖患者接受RA-TKA术后并发症的总体发生率无统计学差异。然而，在严重肥胖（BMI≥35 kg/m2）患者中，观察到并发症发生率升高的非显著趋势。有趣的是，在BMI < 25 kg/m2的患者中，关节纤维化的增加在统计学上有显著差异，这一发现与目前的文献相反。证据等级：三级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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