• Montserrat Núñez, Luis Lozano, Esther Núñez, Sergi Sastre, José Luis Del Val, and Santiago Suso.
• Rheumatology Department, Biomedical Research Institute August Pi i Sunyer (IDIBAPS), Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain, mnunez@clinic.ub.es.
• Obes Surg. 2011 Aug 1;21(8):1203-8.

BackgroundThe impact of obesity on total knee replacement (TKR) outcomes is unclear. Studies use different classifications of obesity and heterogeneous methods, making comparisons difficult. The aim of this study was to evaluate health-related quality of life (HRQL) preoperatively and at 12 months of follow-up in severe and morbidly obese patients with knee osteoarthritis and a control group of nonobese patients undergoing TKR.MethodsCase-control study with 12 months follow-up. HRQL was measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. Sociodemographic variables, comorbidity, body mass index (BMI), degree of intra-operative difficulty (IOD), in-patient data, and postoperative medical data were collected. The effect size (ES) was measured for the different outcome measures. Comparison of the two groups after 12 months of follow-up was made using the t test.ResultsStudy Groupsixty patients (88% women) with a mean age of 70.2 years (SD 6.7) and mean total WOMAC dimension score 61.4 (SD 16.7).Control Group60 matched controls. There were 88% women, with a mean age of 71.7 years (SD 6.7), and a mean WOMAC score of 58.2 (SD 13.4). There were significant improvements in all WOMAC dimensions compared to baseline (p < 0.001) in both groups. There were no differences in WOMAC dimension scores between the two groups at 12 months. The study group had more IOD (p = 0.014) and more-severe complications in the follow up.ConclusionsSevere and morbidly obese and nonobese patients had similar change scores and TKR outcomes in terms of HRQL at 12 months after TKR. Obese patients had more intraoperative difficulties and more-severe postoperative complications.

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