
Thomas Hodo
Tulane University , USATitle: Increased likelihood of low energy knee dislocation after tka in the morbidly obese patient
Abstract
Introduction: The
incidence of total knee arthroplasty (TKA) and obesity in the United States
continues to increase annually. Knee dislocations (KD) occur when an external
mechanical force over comes the restraints of the knee. Previous studies have
linked increased risk of KD due to obesity in native knees. This study aimed to
identify the increased risk of elevated BMI in low energy KD after TKA in
efforts to stratify risks for potential changes in management of obese patients
with TKA.
Methods: Patient
records from 2007-2017 were queried from an administrative claims database to
investigate the rates of KD after TKA. Exclusion criteria included conditions
that would lead to ligamentous laxity, fall from height and motor vehicle
collisions. Dislocation rates were compared with multivariate logistic
regression adjusting for age, gender and presence of diabetes or rheumatoid
arthritis.
Results: Patients
with >35 BMI had a significantly higher risk of KD after TKA compared to
nonobese patients (BMI <30). An increased association with KD after this
threshold with increasing BMI (BMI 40-50, OR: 1.55, 95% CI: 1.11-2.15; BMI
>50, OR 2.5, 95% CI: 1.61-3.77).
Conclusion: Obese
individuals are at a higher risk of dislocation following TKA. Patients with
BMI >35 have a significantly higher risk of dislocation with up to a 2.5
greater likelihood at BMI >50. Providers should have an increased suspicion
of KD in this group of patients and be readily able to assess for neurovascular
compromise related to knee dislocation.
Biography
Thomas Hodo is
current resident at Tulane University in New Orleans, Louisiana, USA. He
received his medical education at the Medical College of Georgia at Augusta
University and received training in biomedical research at Meharry Medical
Colleege in Nashville, Tennessee where he focused on Cancer Immunotherapy. He
will be subspecializing in Musculoskeletal Oncology but also has interest in
Arthroplasty and Trauma.