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Weight and height separated provide better understanding than BMI on the risk of revision after total knee arthroplasty : report of 107,228 primary total knee arthroplasties from the Swedish Knee Arthroplasty Register 2009–2017

Sezgin, Erdem A. LU ; W-Dahl, Annette LU ; Lidgren, Lars LU and Robertsson, Otto LU (2020) In Acta Orthopaedica 91(1). p.94-97
Abstract

Background and purpose — Obesity defined as increased BMI is commonly associated with higher revision rates following total knee arthroplasty (TKA). We examined the effect of BMI on the rate of revision after TKA, for both infection and other reasons, and analyzed weight and height separately to provide better understanding of the risk profile. 

Patients and methods — The Swedish national knee arthroplasty register was used to identify 107,228 patients operated with primary TKA for osteoarthritis between 2009 and 2017. Cox proportional hazards regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for BMI (categories: < 18.5, 18.5–24.9, 25–29.9, 30–34.9, 35–39.9, ≥ 40), weight (categories: <... (More)

Background and purpose — Obesity defined as increased BMI is commonly associated with higher revision rates following total knee arthroplasty (TKA). We examined the effect of BMI on the rate of revision after TKA, for both infection and other reasons, and analyzed weight and height separately to provide better understanding of the risk profile. 

Patients and methods — The Swedish national knee arthroplasty register was used to identify 107,228 patients operated with primary TKA for osteoarthritis between 2009 and 2017. Cox proportional hazards regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for BMI (categories: < 18.5, 18.5–24.9, 25–29.9, 30–34.9, 35–39.9, ≥ 40), weight (categories: < 65, 65–89, 90–114, ≥ 115 kg) and height (categories: < 160, 160–179, ≥ 180 cm.

Results — There were 2,503 revisions in the follow-up period; 1,036 for infection and 1,467 for other reasons. Higher BMI and weight categories were associated with a similar and statistically significantly increased risk of revision for all causes and for infection. The risk of revision for infection was almost twice in the highest BMI and highest weight group: HR = 3.4 (CI 2.3–4.7) and HR = 3.1 (CI 2.5–3.9) respectively. For BMI and weight categories there was no statistically significant association between revision for other reasons than infection, contrary to the tallest height category where it was statistically significant (HR = 1.3 [CI 1.1–1.5]). 

Interpretation — BMI, weight, and height may be associated with different types of risks for revision following TKA.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Orthopaedica
volume
91
issue
1
pages
4 pages
publisher
Taylor & Francis
external identifiers
  • pmid:31698972
  • scopus:85077934757
ISSN
1745-3674
DOI
10.1080/17453674.2019.1688006
language
English
LU publication?
yes
id
8bf457c1-dc7b-40fc-aec3-a37ce33a1290
date added to LUP
2019-12-11 16:05:45
date last changed
2020-12-29 03:21:23
@article{8bf457c1-dc7b-40fc-aec3-a37ce33a1290,
  abstract     = {<p>Background and purpose — Obesity defined as increased BMI is commonly associated with higher revision rates following total knee arthroplasty (TKA). We examined the effect of BMI on the rate of revision after TKA, for both infection and other reasons, and analyzed weight and height separately to provide better understanding of the risk profile. </p><p>Patients and methods — The Swedish national knee arthroplasty register was used to identify 107,228 patients operated with primary TKA for osteoarthritis between 2009 and 2017. Cox proportional hazards regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for BMI (categories: &lt; 18.5, 18.5–24.9, 25–29.9, 30–34.9, 35–39.9, ≥ 40), weight (categories: &lt; 65, 65–89, 90–114, ≥ 115 kg) and height (categories: &lt; 160, 160–179, ≥ 180 cm.</p><p>Results — There were 2,503 revisions in the follow-up period; 1,036 for infection and 1,467 for other reasons. Higher BMI and weight categories were associated with a similar and statistically significantly increased risk of revision for all causes and for infection. The risk of revision for infection was almost twice in the highest BMI and highest weight group: HR = 3.4 (CI 2.3–4.7) and HR = 3.1 (CI 2.5–3.9) respectively. For BMI and weight categories there was no statistically significant association between revision for other reasons than infection, contrary to the tallest height category where it was statistically significant (HR = 1.3 [CI 1.1–1.5]). </p><p>Interpretation — BMI, weight, and height may be associated with different types of risks for revision following TKA.</p>},
  author       = {Sezgin, Erdem A. and W-Dahl, Annette and Lidgren, Lars and Robertsson, Otto},
  issn         = {1745-3674},
  language     = {eng},
  number       = {1},
  pages        = {94--97},
  publisher    = {Taylor & Francis},
  series       = {Acta Orthopaedica},
  title        = {Weight and height separated provide better understanding than BMI on the risk of revision after total knee arthroplasty : report of 107,228 primary total knee arthroplasties from the Swedish Knee Arthroplasty Register 2009–2017},
  url          = {http://dx.doi.org/10.1080/17453674.2019.1688006},
  doi          = {10.1080/17453674.2019.1688006},
  volume       = {91},
  year         = {2020},
}