Canadian Journal of Surgery最新文献

{"title":"Enhanced Recovery After Surgery and next-day discharge after laparoscopic Roux-en-Y gastric bypass.","authors":"Krista Hardy, Caleb Leung, Jonathan Seto, Simon Tewes, Wenjing He, Ashley Vergis","doi":"10.1503/cjs.012923","DOIUrl":"https://doi.org/10.1503/cjs.012923","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic Roux-en-Y gastric bypass (LRYGB) is a common bariatric procedure, but patients often experience extended inpatient stays. Given that Enhanced Recovery After Surgery (ERAS) protocols aim to expedite recovery and discharge, we sought to evaluate the impact of introducing an overnight short-stay unit with ERAS protocols, along with transfer protocols for patients requiring prolonged care.</p><p><strong>Methods: </strong>We retrospectively reviewed prospectively collected data on LRYGBs performed between November 2017 and December 2020. Postoperative evaluations were conducted 16-21 hours after surgery. Patients were educated about potential complications and required to stay within 1 hour of a tertiary centre for 7 days. We analyzed descriptive outcomes including length of stay (LOS), 30-day emergency department (ED) presentations, and 7-day and 30-day readmissions.</p><p><strong>Results: </strong>Among the 439 patients, the postoperative day 1 discharge rate was 94.8%, and the day 2 discharge rate was 1.8%. A small proportion of patients (2.7%) required transfer for anticipated prolonged LOS, primarily for delayed intra-abdominal hemorrhage requiring reoperation (66.7%) and as a precautionary measure for technically challenging procedures (16.7%). Two brief admissions to the intensive care unit occurred, with no deaths. Overall, 45 (10.3%) patients presented to the ED within 30 days, 12 (2.7%) patients were readmitted within 7 days, and 18 (4.1%) patients were readmitted within 30 days. Gastrointestinal intolerance was the most common reason for readmission.</p><p><strong>Conclusion: </strong>An ERAS protocol for LRYGB enabled safe next-day discharge for 94.8% of patients. Rates of ED presentation and readmission aligned with existing literature, supporting the feasibility of next-day discharge for appropriately selected patients. These findings contribute to the evidence base for optimizing postoperative care and enhancing patient outcomes in bariatric surgery.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"68 4","pages":"E274-E280"},"PeriodicalIF":2.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Testing the precautionary principle: a scoping review comparing potable tap and sterile water for irrigation in colonoscopy.","authors":"Hilalion San Ahn, Alexie Leclerc, Jennifer Shamess, Jordi Pardo, Catherine Dube, Alaa Rostom, Natalia Calo, Kednapa Thavorn, Daniel I McIsaac, David Smith, Husein Moloo","doi":"10.1503/cjs.012724","DOIUrl":"https://doi.org/10.1503/cjs.012724","url":null,"abstract":"<p><strong>Background: </strong>Most guidelines recommend use of sterile water in single-use plastic bottles for irrigation in colonoscopy, a recommendation extrapolated from case reports of infection linked to endoscopic retrograde cholangiopancreatography. Our objective was to identify evidence exploring the impact of tap versus sterile water in colonoscopy on patient, health care resource, and environmental outcomes.</p><p><strong>Methods: </strong>We performed a scoping review and included any study examining the effects of irrigation source during colonoscopy. A health information specialist searched Embase, MEDLINE, CINAHL, and Web of Science from inception to March 2024 using Peer Review of Electronic Search Strategies standards. Two reviewers performed screening and data extraction using a standardized form. We conducted a quantitative analysis of patient outcomes.</p><p><strong>Results: </strong>Of 335 identified articles, we included 3. All were prospective studies published between 1996 and 2002. Overall, 137 colonoscopies and 38 flexible sigmoidoscopies were reported. Two studies compared sterile versus tap water, with 7 of 118 (6%) and 35 of 327 (11%) positive water cultures, respectively. There were no clinical adverse events. One study compared tap water at warm versus room temperature and measured patient pain scores (2/10 and 4/10, respectively). Infectious complications were not reported.</p><p><strong>Conclusion: </strong>There is limited evidence to support either tap or sterile water in irrigation for colonoscopy, but potable tap water may be a safe choice and is environmentally and economically more beneficial than sterile water. In the context of the climate crisis and increasing economic health care burden, tap water in reusable bottles should be strongly considered for irrigation in colonoscopy. <b>Registration:</b> Open Science Framework Registry, https://osf.io/8dgck.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"68 4","pages":"E281-E288"},"PeriodicalIF":2.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender representation in professorship and research productivity across all surgical specialties in Canadian academic institutions.","authors":"Stuti M Tanya, Anne Xuan-Lan Nguyen, Maxine Joly-Chevrier, Daiana Roxana Pur, Sanjay Sharma, Fiona Costello, Femida Kherani, Vincent Quoc-Huy Trinh, Isabelle Hardy, Leonardo Lando","doi":"10.1503/cjs.015723","DOIUrl":"10.1503/cjs.015723","url":null,"abstract":"<p><strong>Background: </strong>Disparate gender representation among Canadian academic surgeons is documented; however, the association of academic rank with research productivity across all surgical specialties is not well understood. Our objective was to assess differences in gender representation by academic rank and research productivity metrics for surgical specialties in Canadian academic centres.</p><p><strong>Methods: </strong>This retrospective, cross-sectional, comparative study used online public databases in 2021. Data sources included the Canadian Resident Matching Service program descriptions, College of Physicians and Surgeons databases, the Scopus platform, and professional websites. Gender distribution by academic rank, research productivity metrics, institution, and surgical specialty were tested for a 0.5 proportion rate. We used a generalized logistic regression model adjusting for confounders to assess gender association with ordinally ranked academic rank. We defined significance by <i>p</i> < 0.05 with reported 95% confidence intervals.</p><p><strong>Results: </strong>We assessed 10 surgical specialties across 17 Canadian academic institutions. Women surgeons were underrepresented in 16 out of 17 centres (<i>p</i> < 0.001), comprising the majority in only obstetrics-gynecology (<i>p</i> < 0.001). Women were also less represented as assistant (37%), associate (27%), and full professors (18%) (<i>p</i> < 0.001), with lower mean <i>h</i>-index (6.4, <i>p</i> < 0.001), years active in research (11.5, <i>p</i> < 0.001), number of publications (18, <i>p</i> < 0.001), and <i>m</i>-quotient (0.42, <i>p</i> < 0.001). Multivariate analysis showed that men were more likely to be represented in senior professorship regardless of research productivity, institution, and specialty determinants (odds ratio 1.30-1.33, <i>p</i> = 0.001-0.024).</p><p><strong>Conclusion: </strong>Women surgeons were underrepresented across all academic ranks, were less likely to achieve senior professorship, and had lower research productivity metrics.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"68 3","pages":"E253-E264"},"PeriodicalIF":2.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence Based Reviews in Surgery: a critical appraisal of whole blood resuscitation in injured patients.","authors":"Brodie Nolan, Morgan Schellenberg, Chad G Ball, Kelly N Vogt, Jordan Nantais","doi":"10.1503/cjs.009924","DOIUrl":"10.1503/cjs.009924","url":null,"abstract":"<p><p><b>Summary</b>Although blood transfusion as a clinical practice dates back several centuries, the optimal approach remains controversial. In the last decade there has been renewed interest in whole blood transfusion over component therapy for trauma patients. A recent multicentre prospective study assessed the impact of whole blood resuscitation on survival among injured patients in hemorrhagic shock presenting to trauma centres in the United States. We have undertaken an Evidence Based Review in Surgery of that study to appraise how its authors tackled an important clinical question with increasing relevance in modern trauma practice: What is the role of whole blood in trauma resuscitation?</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"68 3","pages":"E271-E273"},"PeriodicalIF":2.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High- versus low-intensity knowledge translation interventions for surgeons and rates of local tumour recurrence after rectal cancer surgery: an Ontario study.","authors":"Marko Simunovic, Christine Fahim, Vanja Grubac, David R Urbach, Greg Pond, Erin Kennedy, Nancy N Baxter","doi":"10.1503/cjs.012424","DOIUrl":"10.1503/cjs.012424","url":null,"abstract":"<p><strong>Background: </strong>Given that diagnostic, neoadjuvant treatment, and surgical approaches to rectal cancer have changed markedly in the last 25 years, knowledge translation (KT) may be useful to optimize rectal cancer surgery and improve patient outcomes. We sought to evaluate the impact of surgeon-directed KT to improve the quality of rectal cancer surgery on local tumour recurrence in Ontario.</p><p><strong>Methods: </strong>Ontario's 14 health regions were previously categorized into 2 high-intensity and 12 low-intensity KT regions, based on KT methods (e.g., theory, audit, feedback), applied from 2006 to 2012 to improve the quality of rectal cancer surgery. In the high-intensity regions, efforts encouraged preoperative magnetic resonance imaging, appropriate radiation, and optimal surgical technique. We abstracted hospital chart data from across Ontario for a random sample of cases from 2010 to 2012 based on the respective population of a region and the relative hospital case volume within their region. The main study outcome was local tumour recurrence.</p><p><strong>Results: </strong>In the high-intensity and low-intensity KT regions, we reviewed data from 523 (48.6%) and 557 (51.4%) patients, respectively. Descriptive variables (e.g., age, sex, tumour stage) were similar between groups. In the high- and low-intensity regions, the proportion of patients with a permanent stoma was 31.4% and 26.4% (<i>p</i> = 0.08), the proportion with positive radial margins was 8.0% and 6.1% (<i>p</i> = 0.2), and the proportion with local tumour recurrence was 6.3% and 5.2% (<i>p</i> = 0.2), respectively. The adjusted risk of time to local recurrence was similar in the high- and low-intensity KT regions (hazard ratio 0.72, 95% confidence interval 0.50-1.05).</p><p><strong>Conclusion: </strong>The use of resource-intense methods was not associated with improved patient outcomes, including local tumour recurrence. New approaches are needed to optimize the population-level quality of rectal cancer surgery.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"68 3","pages":"E245-E252"},"PeriodicalIF":2.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in opioid distribution and chronic opioid users following outpatient orthopedic surgery: a pre-post intervention study.","authors":"Riley Hemstock, Sheila McRae, Ian Laxdal, Thomas Mutter, Kevin Friesen, Heather J Prior, Jason Old, Gregory Stranges, Devin Lemmex, James Dubberley, Jonathan Marsh, Robert Longstaffe, Peter MacDonald, Jarret Woodmass","doi":"10.1503/cjs.000325","DOIUrl":"10.1503/cjs.000325","url":null,"abstract":"<p><strong>Background: </strong>Outpatient overprescribing of opioids in the postoperative period contributes to the opioid epidemic. Given that patient education and evidence-informed prescription protocols have reduced postoperative opioid use in small, randomized trials, we sought to evaluate the effectiveness of a multimodal opioid reduction protocol, implemented institution-wide at an outpatient Canadian orthopedic surgery centre.</p><p><strong>Methods: </strong>In this pre-post intervention study, we used deidentified health administrative data from a provincial data repository to identify all opioid-naive patients who underwent outpatient shoulder or knee surgery at a single institution between 2013 and 2022. An opioid restriction protocol was implemented in 2019, including an educational pamphlet, perioperative verbal education, and a standardized postoperative analgesic prescription. Outcomes analyzed included dispensed morphine milligram equivalents (MME) per patient within 180 days of surgery and chronic opioid use, defined as opioids dispensed 180-270 days after surgery. Prescriptions dispensed from any provider were included.</p><p><strong>Results: </strong>We included 8244 patients preintervention and 2205 patients postintervention in the analyses. The average MME dispensed per patient decreased by 18% (57.8 MME, 95% confidence interval 45.0-70.6). The proportion of patients who filled opioid prescriptions beyond 180 days after surgery decreased from 4.8% to 2.6% (<i>p</i> < 0.001). These findings remained consistent after adjustment for age, sex, socioeconomic status, mental health, and medical comorbidity in multivariable regression analyses.</p><p><strong>Conclusion: </strong>The volume of opioids dispensed and the number of chronic opioid users were significantly reduced among patients who underwent outpatient orthopedic surgery after the institution-wide implementation of a multimodal postoperative opioid reduction protocol.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"68 3","pages":"E265-E270"},"PeriodicalIF":2.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rural surgical and obstetric facility-level outcomes for index procedures: a retrospective cohort study (2016-2021).","authors":"Jude Kornelsen, Gal Av-Gay, Anshu Parajulee, Nancy Humber, Sean Ebert, Tom Skinner, Kathrin Stoll","doi":"10.1503/cjs.003423","DOIUrl":"10.1503/cjs.003423","url":null,"abstract":"<p><strong>Background: </strong>Many rural communities have lost local access to procedural care, and although rural surgical services have endured in some regions, questions regarding quality and safety of care have persisted. Using retrospective observational data, we sought to compare adverse outcomes of the most common surgical procedures performed at rural facilities in British Columbia and outcomes by provider specialty. Our objective was to show whether the efficacy of surgical care at rural facilities is comparable to that of larger referral facilities and whether family physicians with enhanced surgical skills (FPESS) have outcomes comparable to those of specialists at referral facilities for low-morbidity patients.</p><p><strong>Methods: </strong>We included patients who had a colonoscopy, hernia repair, appendectomy, or cesarean delivery at 1 of 7 rural hospitals in BC that participated in the Rural Surgical and Obstetrics Networks of BC and corresponding referral facilities between 2016 and 2021. To control for differences in the acuity of patients between facility types, we risk stratified data by patient comorbidity level, in addition to adjusting for other demographic differences using multivariable Firth logistic regression analysis. We also compared the outcomes of FPESS with those of regional specialists for low-acuity patients in a similar manner. We calculated adjusted odds ratios (ORs), used tests of noninferiority to obtain <i>p</i> values for the adjusted ORs, and calculated E-values to estimate the extent to which our findings could be due to other unmeasured confounding.</p><p><strong>Results: </strong>Most surgical procedures at rural hospitals were performed by FPESS (<i>n</i> = 4403, 34.9%) and visiting general surgeons (<i>n</i> = 7317, 57.9%). We found that the quality of care at rural facilities was at least equivalent to the quality at referral facilities in rural BC for colonoscopy, hernia repair, and appendectomy, and that FPESS had outcomes at least equivalent to those of specialists for low-acuity patients.</p><p><strong>Conclusion: </strong>Our findings provide evidence in favour of the efficacy of rural procedural care at BC facilities, and although these results are not inherently generalizable to other populations, we believe they illustrate the potential for high-quality rural care for low-acuity procedures in similar settings. These findings are an important step toward documenting rural-specific outcomes and creating attendant benchmarks for rural practice.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"68 3","pages":"E221-E234"},"PeriodicalIF":2.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative radiation exposure in a level 1 trauma centre orthopedic operating room.","authors":"Jeremie Thibault, Walid Naciri, Dominique M Rouleau, Julien Chapleau","doi":"10.1503/cjs.003824","DOIUrl":"10.1503/cjs.003824","url":null,"abstract":"<p><strong>Background: </strong>Although fluoroscopy is used routinely, surgeons and orthopedic residents are inadequately educated about the dangers associated with radiation exposure and protective measures in the operating room. We sought to report the average radiation exposure during common orthopedic trauma procedures for different team members and to determine if the fluoroscopy emitting report is correlated with the radiation measured in the room.</p><p><strong>Methods: </strong>We conducted a prospective observational study over 3 months in a level 1 trauma centre. We collected radiation levels from dosimeters in different standardized locations at 1 m, 2 m, and 3 m from the C-arm machine, labelled as dosimeters A, B, and C, corresponding to the locations of the surgeon, anesthesiologist, and nurse, respectively). We classified mean exposure (and standard deviations [SDs] according to the body part exposed and the dose delivered.</p><p><strong>Results: </strong>We included recordings from 100 patients who underwent surgery for fractures, of which 50 involved a distal extremity, 31 involved a proximal extremity and 19 involved the pelvic area. Dosimeter A (surgeon) recorded a significantly higher amount of radiation at a mean of 20.35 (SD 54.25) μSv than the other 2 dosimeters (B [anesthesiologist]: 0.87 [SD 1.55] μSv; C [nurse]: 0.49 [SD 0.92] μSv), regardless of the fracture location. Higher radiation levels were recorded for fixation of centrally located fractures, followed by lower-extremity fractures and upper-extremity fractures. Half-dose and quarter-dose fluoroscopy emitted statistically lower radiation than standard-dose fluoroscopy. The radiation report from the fluoroscopy machine was highly correlated with the measured radiation (ρ = 0.93; <i>r</i> ² = 0.909, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Radiation exposure is much higher closer to the fluoroscopy machine and decreases following an inverse-square law from the radiation source, becoming negligible at 2 m from the source. Using the low-dose radiation mode can significantly decrease radiation exposure.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"68 3","pages":"E235-E241"},"PeriodicalIF":2.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Silicon scalpels or artificial surgeons: What is coming for our jobs?","authors":"Edward J Harvey, Chad G Ball","doi":"10.1503/cjs.009125","DOIUrl":"10.1503/cjs.009125","url":null,"abstract":"","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"68 3","pages":"E242"},"PeriodicalIF":2.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of obesity on functional outcomes after total knee arthroplasty: a prospective cohort study.","authors":"Mohammad Athar, Raghav Saini, Simrun Chahal, Rabail Siddiqui, Shalyn Littlefield, Lahama Naeem, Sacha Dubois, Kurt Droll, Travis E Marion, David Puskas, Claude Cullinan","doi":"10.1503/cjs.008524","DOIUrl":"10.1503/cjs.008524","url":null,"abstract":"<p><strong>Background: </strong>An increasing number of total knee arthroplasties (TKAs) are performed in people with obesity, but TKAs in this population may come with increased risk of perioperative complications and decreased prosthetic survivorship. Given the lack of conclusive evidence on differences in functional outcomes, we aimed to use the Forgotten Joint Score-12 (FJS-12) to see how body mass index (BMI) affected functional outcomes after TKA.</p><p><strong>Methods: </strong>We recruited patients who underwent primary unilateral TKA because of osteoarthritic changes from January 2018 to November 2021. We collected the Forgotten Joint Score-12 (FJS-12) measure of functional outcomes and the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) preoperatively and 6- and 12-months postoperatively. We also measured length of stay (LOS), readmission, and emergency department (ED) visits. We compared outcomes by BMI category using linear effects models.</p><p><strong>Results: </strong>We recruited 351 patients. No differences were found in LOS, readmissions, and ED visits by BMI category. Compared with the preoperative score, we observed significant differences by BMI category for the 6-month FJS-12 (β = -0.66, <i>p</i> = 0.007) and 12-month WOMAC (β = -0.34, <i>p</i> = 0.02) scores. At 6 months, patients with lower BMI showed a greater change in FJS-12 scores than those with higher BMI. However, by 12 months, all patients appeared to return to similar functional levels regardless of BMI.</p><p><strong>Conclusion: </strong>Despite a slower return to function, patients with elevated BMI were able to return to similar levels of function as those with a lower BMI by 12 months, with no significant differences in readmission, ED visits, or LOS. This similar return to function justifies candidacy for surgery.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"68 3","pages":"E214-E220"},"PeriodicalIF":2.2,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}