Increased operating room time in patients with obesity during primary total knee arthroplasty: conflicts for scheduling.

Obesity is associated with increased complications related to total knee arthroplasty (TKA), but the relationship between body mass index (BMI) and operating room time during TKA is unknown. A total of 454 unilateral primary TKAs (2005-2009) were reviewed and categorized by BMI (normal weight, 18.5-25 kg/m(2); overweight, 25-30 kg/m(2); obese class I, 30-<35 kg/m(2); class II, 35-40 kg/m(2); class III, >40 kg/m(2)). Intraoperative time measurements (total room time, anesthesia induction time, tourniquet time, closing time, surgery time) were compared across the BMI groups. Comparing normal weight to obese class III, time differences were significant in total room time (24 minutes, P < .01), surgery time (16 minutes, P < .01), tourniquet time (7.5 minutes, P < .01), and closure time (8 minutes, P < .01). Armed with this information, BMI can be used to better allocate operating room time for TKA.

[1]  D. Spicer,et al.  Body mass index as a predictor of outcome in total knee replacement , 2001, International Orthopaedics.

[2]  Sunny H. Kim.  Morbid obesity and excessive hospital resource consumption for unilateral primary hip and knee arthroplasty. , 2010, The Journal of arthroplasty.

[3]  K. Flegal,et al.  Prevalence and trends in obesity among US adults, 1999-2008. , 2010, JAMA.

[4]  G. Scuderi**,et al.  Total Knee Arthroplasty in Patients Who Were Obese With 10 Years Followup , 1998, Clinical orthopaedics and related research.

[5]  R. Laskin,et al.  Prolonged Operative Time Correlates with Increased Infection Rate After Total Knee Arthroplasty , 2006, HSS Journal.

[6]  A. Amin,et al.  Total knee replacement in morbidly obese patients. Results of a prospective, matched study. , 2006, The Journal of bone and joint surgery. British volume.

[7]  I. Pinder,et al.  Does body weight influence outcome after total knee arthroplasty? A 1-year analysis. , 2002, The Journal of arthroplasty.

[8]  R. Leach,et al.  Obesity: its relationship to osteoarthritis of the knee. , 1973, Clinical orthopaedics and related research.

[9]  M. Lew,et al.  The effect of patient weight on the functional outcome of total knee arthroplasty. , 1992, Clinical orthopaedics and related research.

[10]  R. Pietrobon,et al.  Trends in epidemiology of knee arthroplasty in the United States, 1990-2000. , 2005, Arthritis and rheumatism.

[11]  H. Vincent,et al.  Effect of obesity on inpatient rehabilitation outcomes following total knee arthroplasty , 2007, Clinical rehabilitation.

[12]  N. Mahomed,et al.  Survival and clinical function of cemented and uncemented prostheses in total knee replacement: a meta-analysis. , 2009, The Journal of bone and joint surgery. British volume.

[13]  B. Owens,et al.  Defining the relationship between obesity and total joint arthroplasty. , 2001, Obesity research.

[14]  A. Astrup,et al.  Obesity : Preventing and managing the global epidemic , 2000 .

[15]  M. Viceconti,et al.  Relationship between obesity and early failure of total knee prostheses , 2009, BMC musculoskeletal disorders.

[16]  J. Batsis,et al.  Resource utilization of total knee arthroplasty patients cared for on specialty orthopedic surgery units. , 2008, Journal of hospital medicine.

[17]  D. Hungerford,et al.  Total knee arthroplasty in obese patients: a comparison with a matched control group. , 2004, The Journal of arthroplasty.

[18]  H. Vincent,et al.  Effect of Obesity on Inpatient Rehabilitation Outcomes after Total Hip Arthroplasty , 2007, Obesity.

[19]  S. Stern,et al.  Total knee arthroplasty in obese patients. , 1990, The Journal of bone and joint surgery. American volume.

[20]  Nicole de Guia,et al.  Obesity and joint replacement surgery in Canada: findings from the Canadian Joint Replacement Registry (CJRR). , 2006, Healthcare policy = Politiques de sante.

[21]  R. Bourne,et al.  The impact of morbid obesity on patient outcomes after total knee arthroplasty. , 2008, The Journal of arthroplasty.

[22]  P. Lotke,et al.  Total Knee Arthroplasty in Morbidly Obese Patients* , 1998, The Journal of bone and joint surgery. American volume.

[23]  A. Amin,et al.  Does obesity influence the clinical outcome at five years following total knee replacement for osteoarthritis? , 2006, The Journal of bone and joint surgery. British volume.

[24]  D. Murray,et al.  Obesity in total hip replacement. , 2008, The Journal of bone and joint surgery. British volume.

[25]  D. Felson,et al.  Obesity and knee osteoarthritis. The Framingham Study. , 1988, Annals of internal medicine.

[26]  J. Pritchett,et al.  Knee replacement in morbidly obese women. , 1991, Surgery, gynecology & obstetrics.

[27]  S. Sastre,et al.  Relationship Between Knee Anthropometry and Surgical Time in Total Knee Arthroplasty in Severely and Morbidly Obese Patients: A New Prognostic Index of Surgical Difficulty , 2008, Obesity surgery.

[28]  D. Hungerford,et al.  The outcome of total knee arthroplasty in obese patients. , 2004, The Journal of bone and joint surgery. American volume.

[29]  D Coggon,et al.  Long-term outcome following total knee arthroplasty: a controlled longitudinal study , 2008, Annals of the rheumatic diseases.

[30]  Robert S. Dittus,et al.  Health-Related Quality of Life after Knee Replacement: Results of the Knee Replacement Patient Outcomes Research Team Study* , 1998 .

[31]  D. Felson,et al.  Body weight, body mass index, and incident symptomatic osteoarthritis of the hand, hip, and knee. , 1999, Epidemiology.

[32]  K. Hegmann,et al.  Relationships between body mass indices and surgical replacements of knee and hip joints. , 2003, American journal of preventive medicine.

[33]  M. Ritter,et al.  Implant migration and failure in total knee arthroplasty is related to body mass index and tibial component size. , 2008, The Journal of arthroplasty.

[34]  Paul DeVita,et al.  Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. , 2005, Arthritis and rheumatism.

[35]  G. Gillespie,et al.  Obesity and knee arthroplasty. , 2007, The Knee.

[36]  Hermann Brenner,et al.  Obesity, overweight and patterns of osteoarthritis: the Ulm Osteoarthritis Study. , 2000, Journal of clinical epidemiology.