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Total Knee Arthroplasty (TKA) MCQs

Practice Set 5 of 23

This practice set contains high-yield board review questions covering key concepts in Total Knee Arthroplasty (TKA). Each clinical scenario is designed to test your diagnostic and management skills relevant to this subspecialty.

Question 81

Topic: Total Knee Arthroplasty (TKA)

According to the principles outlined, a 25-year-old patient with a complex lower limb deformity requires a true anteroposterior (AP) standing radiograph. Which of the following accurately defines the 'knee forward position' essential for obtaining this view?

. A. The patient's feet are positioned with the toes pointing straight ahead, parallel to the imaging cassette.
. B. The patient's hips are externally rotated until the femoral condyles appear symmetrical on the radiograph.
. C. The patella is perfectly centered between the medial and lateral femoral condyles, irrespective of foot position.
. D. The patient's knees are flexed to 30 degrees to ensure optimal joint space visualization.
. E. The fibular head is superimposed over the lateral aspect of the tibia.

Correct Answer & Explanation

. C. The patella is perfectly centered between the medial and lateral femoral condyles, irrespective of foot position.

Explanation

Correct Answer: CThe text explicitly states: "The gold standard for a true AP view is theknee forward position. This position is defined by one simple, critical anatomical landmark: the patella must be perfectly centered between the medial and lateral femoral condyles." It further clarifies that this is achieved "irrespective of the foot's final position."Incorrect Options:A. The patient's feet are positioned with the toes pointing straight ahead, parallel to the imaging cassette:The text identifies this as "the most common error in radiography suites" and a technique that "completely ignores underlying tibial or femoral torsion, projecting a distorted 2D image."B. The patient's hips are externally rotated until the femoral condyles appear symmetrical on the radiograph:While aiming for symmetry is part of good imaging, the specific definition of the knee forward position focuses on the patella's relationship to the femoral condyles, not hip rotation as the primary determinant.D. The patient's knees are flexed to 30 degrees to ensure optimal joint space visualization:A true AP standing radiograph for deformity analysis is typically performed with the knee in full extension, not flexed, to assess mechanical alignment accurately.E. The fibular head is superimposed over the lateral aspect of the tibia:This describes a radiographic sign of rotation, but it is not the definition of the knee forward position itself. The goal is to avoid such superimposition by achieving the knee forward position.

Question 82

Topic: Total Knee Arthroplasty (TKA)
A 47-year-old obese man with a body mass index of 42 comes into the office with left knee pain 1 year after undergoing an uncomplicated left medial unicompartmental knee arthroplasty (UKA). Radiographs show a loose tibial component in varus. What is the most appropriate next step to treat this failed construct?
. Aspiration of joint fluid to obtain a cell count
. Revision of the UKA using primary total knee arthroplasty (TKA) components
. Revision of the UKA using a revision TKA with augments
. Procurement of the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level

Correct Answer & Explanation

. Procurement of the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level

Explanation

DISCUSSION: This patient likely is experiencing failure of the UKA secondary to poor patient selection. In this young, heavy man, the component likely loosened due to the ongoing varus alignment of the knee and his elevated weight. Despite this likely scenario, the next step is determining whether an infection is the cause of his pain. Prior to obtaining an aspiration, the surgeon can order ESR and CRP studies to determine whether aspiration is warranted. If the laboratory studies are unremarkable, the surgeon likely can forgo the aspiration and proceed to a revision TKA with possible augments on standby.

Question 83

Topic: Total Knee Arthroplasty (TKA)

A 65-year-old female undergoes a primary total knee arthroplasty (TKA). Postoperatively, she develops lateral patellar subluxation. Radiographic and CT evaluation reveals that the tibial component was inadvertently placed in excessive internal rotation. How does this specific malrotation alter the biomechanics of the extensor mechanism?

. It medialize the tibial tubercle relative to the trochlear groove, decreasing the Q angle.
. It increases tension on the medial patellofemoral ligament, causing medial subluxation.
. It lateralizes the tibial tubercle relative to the trochlear groove, increasing the Q angle.
. It inherently causes patella baja, resulting in lateral tracking.
. It decreases the patellofemoral contact pressure, leading to patellar instability.

Correct Answer & Explanation

. It lateralizes the tibial tubercle relative to the trochlear groove, increasing the Q angle.

Explanation

Internal rotation of the tibial component effectively lateralizes the tibial tubercle relative to the femoral trochlea. This increases the Q angle, directly causing lateral patellar maltracking and subluxation.

Question 84

Topic: Total Knee Arthroplasty (TKA)

A 68-year-old male presents with recurrent knee effusions and a sensation of the knee 'giving way' when descending stairs, 18 months after a primary posterior-stabilized TKA. Ligamentous examination demonstrates excessive anterior-posterior translation in 90 degrees of flexion, but the knee is perfectly stable in full extension. Radiographs show no loosening. What technical error during the index procedure is the most likely cause of this instability?

. Under-resection of the distal femur
. Excessive resection of the posterior femoral condyles
. Inadequate resection of the proximal tibia
. Using an excessively thick polyethylene insert
. Placing the femoral component in excessive external rotation

Correct Answer & Explanation

. Excessive resection of the posterior femoral condyles

Explanation

Flexion instability (stable in extension, unstable in flexion) in TKA is typically caused by a loose flexion gap. The most common technical error leading to this is excessive resection of the posterior femoral condyles or undersizing the femoral component in the AP plane.

Question 85

Topic: Total Knee Arthroplasty (TKA)
For this patient, which TKA design is most appropriate?
. Bicruciate-retaining TKA
. Unicompartmental arthroplasty
. Hinged TKA
. Posterior substitution TKA

Correct Answer & Explanation

. Posterior substitution TKA

Explanation

DISCUSSION: TKA in the setting of valgus deformities poses different challenges than those encountered when varus deformities are present. Most valgus alignment is attributable to a deformity of the distal femur rather than the proximal tibia, as seen in varus knees. One of the major anatomical differences is a hypoplastic lateral femoral condyle which, when used as a rotational reference point, can lead to internal rotation of the femoral component if not recognized. This malrotation will in turn lead to patellofemoral maltracking or instability, which is a common complication associated with primary TKA. The deformity is too severe to consider a bicruciate-retaining TKA or unicompartmental arthroplasty and does not necessitate a hinged TKA.

Question 86

Topic: Total Knee Arthroplasty (TKA)
Figure below shows the standing AP radiograph obtained from a 55-year-old man who has a 5-year history of daily left knee medial joint line pain with weight-bearing activities. He denies night pain or symptoms of instability. On examination, his range of motion is 0° to 140°. He has a mild, fully correctable varus deformity and a negative Lachman test result. Nonsurgical treatment has failed. Unicompartmental knee arthroplasty (UKA) is discussed with the patient. The most appropriate next radiographic evaluation should be
. MRI of the left knee to evaluate the lateral compartment.
. a CT arthrogram to evaluate the status of the medial and lateral meniscus.
. a stress radiograph to evaluate correction of the varus deformity.
. a sunrise view to determine the status of the patellofemoral joint.

Correct Answer & Explanation

. a stress radiograph to evaluate correction of the varus deformity.

Explanation

DISCUSSION: A patient with medial compartment arthritis and a correctable varus deformity with no clinical or examination findings of knee instability most likely has an intact anterior cruciate ligament (ACL). The pattern of medial compartment osteoarthritis most commonly associated with an intact ACL is that of anteromedial osteoarthritis. An incompetent ACL is commonly associated with a fixed varus deformity and radiographic signs of posteromedial wear. An incompetent ACL is a relative contraindication to a mobile-bearing UKA. When evaluating patients for a mobile-bearing UKA, a stress radiograph aids the orthopaedic surgeon in determining the correction of the varus deformity and assessing the lateral compartment. An inability to fully correct the deformity or narrowing of the lateral compartment with valgus stress should influence the surgeon against UKA. Joint registries across the world have shown decreased survivorship associated with TKA and UKA in men compared with other age groups, but survivorship is lower for UKA than for TKA. No studies to date have shown any differences in survivorship between fixed-bearing and mobile-bearing UKAs. The complication that is unique to mobile-bearing UKA is bearing spinout, which occurs in less than 1% of mobile-bearing UKA procedures. In vivo and in vitro polyethylene wear in mobile-bearing UKA are low. Arthritis may progress faster in patients with mobile-bearing UKAs than in those with fixed-bearing UKAs.

Question 87

Topic: Total Knee Arthroplasty (TKA)
A woman who underwent total knee replacement 18 months ago has had 3 weeks of moderate drainage from a previously healed wound. What is the most appropriate treatment?
. Vacuum-assisted wound closure dressing
. Intravenous antibiotics for 6 weeks, followed by long-term oral antibiotic administration
. Irrigation and debridement, followed by polyethylene exchange
. Two-stage debridement and reconstruction

Correct Answer & Explanation

. Two-stage debridement and reconstruction

Explanation

Discussion: This situation represents a definitively and chronically infected knee replacement. Antibiotic therapy alone might suppress the infection but would not eradicate it. Debridement and polyethylene exchange would be appropriate treatment for an early postoperative infection. The treatment of choice is to perform a two-stage debridement and reconstruction. Although not among the listed choices, an aspiration or culture could be done presurgically and might help clinicians identify the best antibiotics to treat the condition. Antibiotic selection would not affect the need for the two-stage reconstruction, however.

Question 88

Topic: Total Knee Arthroplasty (TKA)

Figure below shows the standing AP radiograph obtained from a 55-year-old man who has a 5-year history of daily left knee medial joint line pain with weight-bearing activities. He denies night pain or symptoms of instability. On examination, his range of motion is 0° to 140°. He has a mild, fully correctable varus deformity and a negative Lachman test result. Nonsurgical treatment has failed. What is the UKA survivorship for a 55- year-old patient, compared with the survivorship for total knee arthroplasty?

. Equal at 10 years B. Lower at 10 years C. Higher at 10 years
. Not known when using a mobile-bearing UKA

Correct Answer & Explanation

. Equal at 10 years B. Lower at 10 years C. Higher at 10 years

Explanation

DISCUSSION:A  patient  with  medial  compartment  arthritis  and  a  correctable  varus  deformity  with  no  clinical  or examination findings of knee instability most likely has an intact anterior cruciate ligament (ACL). The pattern of medial compartment osteoarthritis most commonly associated with an intact ACL is that of anteromedial osteoarthritis. An incompetent ACL is commonly associated with a fixed varus deformity and radiographic signs of posteromedial wear. An incompetent ACL is a relative contraindication to a mobile-bearing UKA. When evaluating patients for a mobile-bearing UKA, a stress radiograph aids the orthopaedic  surgeon  in  determining  the  correction  of  the  varus  deformity  and  assessing  the  lateral compartment. An inability to fully correct the deformity or narrowing of the lateral compartment with valgus stress should influence the surgeon against UKA. Joint registries across the world have shown decreased  survivorship  associated  with  TKA  and  UKA  in  men  compared  with  other  age  groups,  but survivorship  is  lower  for  UKA  than  for  TKA.  No  studies  to  date  have  shown  any  differences  in survivorship  between  fixed-bearing  and  mobile-bearing  UKAs.  The  complication  that  is  unique  to mobile-bearing  UKA  is  bearing  spinout,  which  occurs  in  less  than  1%  of  mobile-bearing  UKA procedures. In vivo and in vitro polyethylene wear in mobile-bearing UKA are low. Arthritis may progressfaster in patients with mobile-bearing UKAs than in those with fixed-bearing UKAs.

Question 89

Topic: Total Knee Arthroplasty (TKA)
A 70-year-old man reports symptomatic medial knee pain that has become progressively worse during the past year. MRI reveals a complex, posterior horn medial meniscus tear with associated medial lateral and patellofemoral cartilage defects. Radiographs reveal medial joint space narrowing and osteophytes in the other compartments. What treatment is most likely to provide long-term, durable relief of symptoms?
. High tibial osteotomy
. Total knee replacement
. Unicondylar knee replacement
. Arthroscopic partial meniscectomy

Correct Answer & Explanation

. Total knee replacement

Explanation

DISCUSSION: Total knee replacement is a well-established surgery for diffuse, symptomatic osteoarthritis of the knee joint, and its efficacy has been shown in many studies. According to the 2008 AAOS Clinical Practice Guideline, Treatment of Osteoarthritis of the Knee, arthroscopy in the setting of existing osteoarthritis is efficacious for relieving the signs and symptoms of a torn meniscus but not for osteoarthritis. Likewise, in young and active patients, clinical outcomes show improvement after realignment osteotomy for single-compartment osteoarthritis. Unicondylar knee replacement is not indicated for tricompartmental disease of the knee.

Question 90

Topic: Total Knee Arthroplasty (TKA)
When balancing gaps in the coronal plane, what structure preferentially impacts the flexion space more than the extension space?
. Iliotibial band
. Popliteus tendon
. Lateral collateral ligament
. Lateral head of the gastrocnemius

Correct Answer & Explanation

. Popliteus tendon

Explanation

In the setting of valgus deformities, TKA poses different challenges than those encountered when varus deformities are present. The popliteus tendon is a primary stabilizer of the lateral compartment and its release can preferentially increase the flexion gap compared to the extension gap.

Question 91

Topic: Total Knee Arthroplasty (TKA)

Kinematic testing of patellofemoral motion demonstrates that malalignment that produces increased Q angle causes a shift of the patella laterally in the trochlear groove and is most pronounced during what phase of the flexion arc? Review Topic

. 0 to 15 degrees
. 20 to 30 degrees
. 40 to 90 degrees
. 100 to 120 degrees
. 130 to 140 degrees

Correct Answer & Explanation

. 40 to 90 degrees

Explanation

Dynamic patellofemoral joint contact measurements on cadaveric knees with simulated increased Q angle demonstrated that forces shifted to the lateral facet. The lateral shift in the patella was most pronounced from 40 to 90 degrees of flexion. At lower degrees of flexion, the lateral shift was significantly less. At higher degrees of flexion, the continued shift of the patella was not as pronounced.

Question 92

Topic: Total Knee Arthroplasty (TKA)
A 65-year-old man reports symptomatic medial knee pain that has become progressively worse during the past year. MRI reveals a complex, posterior horn medial meniscus tear with associated medial lateral and patellofemoral cartilage defects. Radiographs reveal medial joint space narrowing and osteophytes in the other compartments. What treatment is most likely to provide long-term, durable relief of symptoms?
. High tibial osteotomy
. Total knee replacement
. Unicondylar knee replacement
. Arthroscopic partial meniscectomy

Correct Answer & Explanation

. Total knee replacement

Explanation

Total knee replacement is a well-established surgery for diffuse, symptomatic osteoarthritis of the knee joint, and its efficacy has been shown in many studies. According to the 2008 AAOS Clinical Practice Guideline, Treatment of Osteoarthritis of the Knee, arthroscopy in the setting of existing osteoarthritis is efficacious for relieving the signs and symptoms of a torn meniscus but not for osteoarthritis. Likewise, in young and active patients, clinical outcomes show improvement after realignment osteotomy for single-compartment osteoarthritis. Unicondylar knee replacement is not indicated for tricompartmental disease of the knee.

Question 93

Topic: Total Knee Arthroplasty (TKA)
A 77-year-old man who underwent right total knee replacement surgery 2 and a half years ago has had knee pain since surgery. The pain is diffuse, constant, and made worse with activity. He notes warmth and swelling in his knee. Examination shows a well-healed incision, no erythema, moderate warmth, synovitis, and an effusion. The knee is stable, and has an arc of flexion between 3° and 120°. Radiographs show well-fixed and well-aligned implants. What is the most appropriate initial treatment?
. Knee aspiration for culture
. CT of the knee to assess implant rotation
. Indium-111 leukocyte/technetium-99m sulfur colloid scan of the knee
. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) laboratory studies

Correct Answer & Explanation

. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) laboratory studies

Explanation

DISCUSSION: This patient's history and physical findings are concerning for deep infection. Inflammatory markers, including ESR and CRP, should be obtained first. If the levels are elevated, knee aspiration should be performed for the synovial cell count and culture. A bone scan is not indicated in an initial investigation for deep infection; it is rarely helpful and is not cost effective. CT to assess implant rotation is an appropriate investigation for knee pain when the clinical scenario is not suspicious for a deep infection and when infection has been excluded.

Question 94

Topic: Total Knee Arthroplasty (TKA)

below shows the standing AP radiograph obtained from a year-old man who has a year history of daily left knee medial joint line pain with weight-bearing activities. He denies night pain or symptoms of instability. On examination, his range of motion is 0° to 140°. He has a mild, fully correctable varus deformity and a negative Lachman test result. Nonsurgical treatment has failed. Unicompartmental knee arthroplasty (UKA) is discussed with the patient. The most appropriate next radiographic evaluation should be

. MRI of the left knee to evaluate the lateral compartment.
. a CT arthrogram to evaluate the status of the medial and lateral meniscus. C. a stress radiograph to evaluate correction of the varus deformity.
. a sunrise view to determine the status of the patellofemoral joint.

Correct Answer & Explanation

. MRI of the left knee to evaluate the lateral compartment.

Explanation

DISCUSSION:A  patient  with  medial  compartment  arthritis  and  a  correctable  varus  deformity  with  no  clinical  or examination findings of knee instability most likely has an intact anterior cruciate ligament (ACL). The pattern of medial compartment osteoarthritis most commonly associated with an intact ACL is that of anteromedial osteoarthritis. An incompetent ACL is commonly associated with a fixed varus deformity and radiographic signs of posteromedial wear. An incompetent ACL is a relative contraindication to a mobile-bearing UKA. When evaluating patients for a mobile-bearing UKA, a stress radiograph aids the orthopaedic  surgeon  in  determining  the  correction  of  the  varus  deformity  and  assessing  the  lateral compartment. An inability to fully correct the deformity or narrowing of the lateral compartment with valgus stress should influence the surgeon against UKA. Joint registries across the world have shown decreased  survivorship  associated  with  TKA  and  UKA  in  men  compared  with  other  age  groups,  but survivorship  is  lower  for  UKA  than  for  TKA.  No  studies  to  date  have  shown  any  differences  in survivorship  between  fixed-bearing  and  mobile-bearing  UKAs.  The  complication  that  is  unique  to mobile-bearing  UKA  is  bearing  spinout,  which  occurs  in  less  than  1%  of  mobile-bearing  UKA procedures. In vivo and in vitro polyethylene wear in mobile-bearing UKA are low. Arthritis may progressfaster in patients with mobile-bearing UKAs than in those with fixed-bearing UKAs.

Question 95

Topic: Total Knee Arthroplasty (TKA)

A complication unique to computer navigation of total knee arthroplasty (TKA) is

. femoral shaft fracture.
. intercondylar femur fracture.
. ligament disruption.
. nerve palsy.

Correct Answer & Explanation

. femoral shaft fracture.

Explanation

DISCUSSIONThreaded pins are frequently inserted into the femoral shaft and tibial shafts or proximal tibia to attach arrays for tracking devices. There have been case reports of fractures propagating through the pin tracks, which is a complication unique to computer navigation. Intercondylar fractures can occur following posterior stabilized TKA. Vascular injury, ligament disruption, and nerve palsy are rare complications following TKA performed with or without computer navigation.CLINICAL SITUATION FOR QUESTIONS 111 THROUGH 113Figure 111 is the anteroposterior radiograph of a 79-year-old woman with a presurgical diagnosis of osteonecrosis who sustained a periprosthetic tibia fracture following her total knee arthroplasty (TKA).

Question 96

Topic: Total Knee Arthroplasty (TKA)

A year-old obese man with a body mass index of 42 comes into the office with left knee pain 1 year after undergoing an uncomplicated left medial unicompartmental knee arthroplasty (UKA). Radiographs show a loose tibial component in varus. What is the most appropriate next step to treat this failed construct?

. Aspiration of joint fluid to obtain a cell count
. Revision of the UKA using primary total knee arthroplasty (TKA) components
. Revision of the UKA using a revision TKA with augments
. Procurement of the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level

Correct Answer & Explanation

. Aspiration of joint fluid to obtain a cell count

Explanation

DISCUSSION:This patient likely is experiencing failure of the UKA secondary to poor patient selection. In this young, heavy man, the component likely loosened due to the ongoing varus alignment of the knee and his elevatedweight. Despite this likely scenario, the next step is determining whether an infection is the cause of his pain. Prior to obtaining an aspiration, the surgeon can order ESR and CRP studies to determine whether aspiration  is  warranted.  If  the  laboratory  studies  are  unremarkable,  the  surgeon  likely  can  forgo  theaspiration and proceed to a revision TKA with possible augments on standby.

Question 97

Topic: Total Knee Arthroplasty (TKA)

A 47-year-old obese man with a body mass index of 42 comes into the office with left knee pain 1 year after undergoing an uncomplicated left medial unicompartmental knee arthroplasty (UKA). Radiographs show  a  loose  tibial  component  in  varus.  What  is  the  most  appropriate  next  step  to  treat  this  failed construct?

. Aspiration of joint fluid to obtain a cell count
. Revision of the UKA using primary total knee arthroplasty (TKA) components
. Revision of the UKA using a revision TKA with augments
. Procurement of the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level

Correct Answer & Explanation

. Aspiration of joint fluid to obtain a cell count

Explanation

DISCUSSION:This patient likely is experiencing failure of the UKA secondary to poor patient selection. In this young, heavy man, the component likely loosened due to the ongoing varus alignment of the knee and his elevatedweight. Despite this likely scenario, the next step is determining whether an infection is the cause of his pain. Prior to obtaining an aspiration, the surgeon can order ESR and CRP studies to determine whether aspiration  is  warranted.  If  the  laboratory  studies  are  unremarkable,  the  surgeon  likely  can  forgo  theaspiration and proceed to a revision TKA with possible augments on standby.

Question 98

Topic: Total Knee Arthroplasty (TKA)
Resurfacing the patella during a total knee replacement is strongly indicated when the diagnosis is
. Rheumatoid arthritis
. Posttraumatic arthritis
. Degenerative osteoarthritis
. Osteonecrosis of the tibial plateau
. Osteonecrosis of the medial femoral condyle

Correct Answer & Explanation

. Rheumatoid arthritis

Explanation

A study by Boyd et al. was performed to determine patellar complications after TKA, with the use of an unconstrained prosthesis, with and without resurfacing of the patella. Chronic pain (post-operative, peripatellar pain) in the group that had not had resurfacing was noted in 40 (13 percent) of the 300 knees that were affected by inflammatory arthritis (rheumatoid arthritis [RA], juvenile RA and miscellaneous subcategories), and in 11 (6 percent) of the 195 knees affected by degenerative osteoarthrosis. A revision to resurface the patella was performed in all 51 knees that caused chronic pain and had not had resurfacing of the patella. Hence, chronic pain after TKA without resurfacing the patella was more common in knees affected by rheumatoid arthritis than in those affected by degenerative osteoarthritis. The authors of the study recommend that the patella be resurfaced when an unconstrained prosthesis is used in patients with a diagnosis of inflammatory arthritis and to a lesser degree osteoarthrosis.

Question 99

Topic: Total Knee Arthroplasty (TKA)
A 70-year-old woman who underwent total knee replacement 18 months ago has had 3 weeks of moderate drainage from a previously healed wound. What is the most appropriate treatment?
. Vacuum-assisted wound closure dressing
. Intravenous antibiotics for 6 weeks, followed by long-term oral antibiotic administration
. Irrigation and debridement, followed by polyethylene exchange
. Two-stage debridement and reconstruction

Correct Answer & Explanation

. Two-stage debridement and reconstruction

Explanation

This situation represents a definitively and chronically infected knee replacement. Antibiotic therapy alone might suppress the infection but would not eradicate it. Debridement and polyethylene exchange would be appropriate treatment for an early postoperative infection. The treatment of choice is to perform a two-stage debridement and reconstruction. Although not among the listed choices, an aspiration or culture could be done presurgically and might help clinicians identify the best antibiotics to treat the condition. Antibiotic selection would not affect the need for the two-stage reconstruction, however.

Question 100

Topic: Total Knee Arthroplasty (TKA)

Figures 174a and 174b are the radiograph and clinical photograph of a 64-year-old obese woman (body mass index [BMI] of 48) who has controlled diabetes and hypertension. She has failed nonsurgical treatment and a weight loss program. She is considering total knee arthroplasty (TKA). What is the most significant postsurgical risk for this patient?

. Dissatisfaction after TKA
. Periprosthetic infection and wound complications
. Implant loosening
. Thromboembolic disease

Correct Answer & Explanation

. Dissatisfaction after TKA

Explanation

DISCUSSIONThe literature has demonstrated increased risk for complications among obese patients undergoing TKA (10%-30%). An evaluation of TKA among obese patients revealed 3- to 9-fold higher incidence of wound complications and deep-seated infection. Belmont and associates demonstrated that patients with a BMI higher than 40 are at higher risk for overall complications than patients with a BMI lower than 25, with a particularly high risk for developing local wound complications and infection. An increased risk for thromboembolic complications was not shown among obese patients undergoing TKA. Patient-reported outcome scores among obese patients undergoing TKA are equivalent to those of nonobesepatients. There are conflicting data regarding the outcome and survivorship following TKA for obese patients. Although some studies show a difference in patient-reported outcomes at differing postsurgical intervals, most obese patients undergoing TKA are satisfied with the procedure.

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