Primary Total Knee Arthroplasty in Obese Patients; A Systematic Review

Zonfoly, Amr Ibrahim Salem; Elngehy, Alaa Ahmed Moustafa; Younis, Mohamed Hamdy Mohamed Abdelh; Eissa, Ahmad Hassan Zaki

doi:10.21608/zumj.2025.359380.3836

Primary Total Knee Arthroplasty in Obese Patients; A Systematic Review

Document Type : Systematic review

Authors

¹ Assistant Professor of Orthopedic Surgery, Faculty of Medicine, Zagazig university

² Professor of Orthopedic Surgery, Faculty of Medicine, Zagazig university

³ MBBCH, Faculty of Medicine, Alexandria university

⁴ Lecturer of Orthopedic Surgery, Faculty of Medicine, Zagazig university

10.21608/zumj.2025.359380.3836

Abstract

Background: According to the World Health Organization (WHO), 500 million people around the globe are overweight. There is a growing demand for TKR due to the increased prevalence of OA, which is exacerbated by both the aging population and the obesity epidemic. Obesity and a high body mass index (BMI) may reduce the lifespan of primary care physicians. Implant survivability was substantially reduced in severely obese patients compared to obese and nonobese patients after an average 5-year follow-up. The aim of this systematic review is to assess relevant, up-to-date data on the safety, outcomes, and complications associated with total knee replacement in morbidly obese patients. And the impact of these complications on total knee replacement on the patients. Review also aiming to avoid these complications and improve total knee arthroplasty decision in the view of these data.

Methods: In the beginning, we found 241 studies when we searched five databases. There were 197 unique papers left after removing duplicate research. After perusing the article titles and abstracts, 59 studies were found to be possibly relevant and were subjected to full-text evaluation as part of the screening procedure.

Results: The Postoperative Knee Society objective score was mentioned in seven distinct studies including 3138 patients in both groups, 400 patients in the morbid obesity group, and 2738 patients in the non-obese group.

Conclusion: this study demonstrated that obesity negatively impacts functional outcomes following total knee arthroplasty. Furthermore, obesity was linked to an increased rate of complications after the procedure.

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