Abstract
This study aims to investigate clinical and functional factors in patients undergoing
unilateral and simultaneous bilateral total knee arthroplasty (TKA) who were classified
into subgroups of nonobese, obese, and morbidly obese, and to determine perioperative
and postoperative complications. We conducted an evaluation of 489 nonobese, obese,
and morbidly obese patients who underwent TKA due to primary knee osteoarthritis between
January 2006 and December 2013. The arthroplasties were performed by three different
surgeons. Patients who underwent unilateral (group 1) or simultaneous bilateral (group
2) TKAs were divided into subgroups in accordance with BMI levels, that is, (a) nonobese
(BMI < 30 kg/m2), (b) obese (BMI = 30–34.9 kg/m2), and (c) morbidly obese (BMI ≥35 kg/m2). Clinical and functional assessments were performed using Knee Society Scores (KSSs),
the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC), and range
of motion (ROM) values. Perioperative and early postoperative complications were assessed.
The mean follow-up period was 46.65 months (minimum: 24 months; maximum: 84 months).
There were no significant differences between the patients undergoing unilateral or
simultaneous bilateral TKA procedures regarding postoperative ROM, WOMAC indices,
and KSSs (p > 0.05), except for morbidly obese patients. Most intraoperative and early postoperative
complications occurred in the morbidly obese group, especially in those undergoing
simultaneous bilateral TKA procedures (p < 0.001). Unilateral and simultaneous bilateral TKA procedures showed no differences
regarding ROM, clinical scores, and perioperative and early postoperative complications
in nonobese and obese patients. A moderate increase was detected in complication rates
in the unilateral TKA morbidly obese patients (group 1c); however, morbidly obese
patients constituted the major risk group in simultaneous bilateral TKA patients (group
2c) regarding clinical scores (lower WOMAC scores and KSSs) and the development of
complications.
Keywords
body mass index - unilateral total knee arthroplasty - bilateral total knee arthroplasty
