Total Knee Arthroplasty in the Obese Patient

Obesity has become a nationwide epidemic. There is a clear association between obesity and numerous health problems, including knee arthritis, and an estimated 60% of total knee arthroplasty (TKA) patients are obese. Infection, wound healing complications, and other medical complications are considerably more common in the obese TKA patient. Patients with morbid obesity (body mass index >40) are at especially high risk of complications and inferior functional outcome after TKA. A preoperative medical or surgical weight-loss program may reduce the risks associated with TKA in this high-risk population. Compromised surgical exposure can make TKA technically challenging. Although satisfactory results can be obtained, the obese patient needs to have reasonable expectations regarding the outcome of total knee replacement.