Effect of obesity on inpatient rehabilitation outcomes following total knee arthroplasty

• Published in: Clinical rehabilitation Vol. 21; no. 2; pp. 182 - 190
• Main Authors: Vincent, Heather K, Vincent, Kevin R, Lee, Laura W, Alfano, Alan P
• Format: Journal Article
• Language: English
• Published: Thousand Oaks, CA SAGE Publications 01.02.2007; Sage Publications Ltd
• Subjects: Aged; Aged, 80 and over; Arthroplasty; Arthroplasty, Replacement, Knee - economics; Arthroplasty, Replacement, Knee - rehabilitation; Clinical outcomes; Disability Evaluation; Female; Hospital Charges; Hospitalization; Humans; Knee Joint - physiopathology; Knees; Male; Obese people; Obesity; Obesity - complications; Obesity - economics; Outcome Assessment (Health Care); Range of Motion, Articular - physiology; Rehabilitation; Reoperation; Retrospective Studies; Virginia; Virginia
• ISSN: 0269-2155; 1477-0873
• DOI: 10.1177/0269215506069245

Objectives: To examine obesity effects on outcomes following inpatient rehabilitation in patients following primary total knee arthroplasty or revision total knee arthroplasty. Design: Retrospective, comparative study. Setting: Fifty-bed, university-affiliated rehabilitation hospital. Patients: Obese (N = 139; body mass index >30 kg/m2) and non-obese (N = 146; body mass indexB <30 kg/m2) total knee arthroplasty patients. Participants were further stratified based on total knee arthroplasty type, primary and revision for a total of four groups. Intervention: Interdisciplinary inpatient rehabilitation. Main measures: Range of motion, length of stay, Functional Independence Measure (FIM) scores, FIM efficiency scores, total and daily hospital charges, and discharge disposition location. Results: Range of motion and FIM scores improved from admission to discharge in both obese and non-obese patients regardless of total knee arthroplasty type. FIM efficiency was lower in revision than primary total knee arthroplasty (2.8 versus 3.6 patients/day; P < 0.005) but not different between obese and non-obese groups. Total hospital charges were lower for the primary than for the revision patients (P < 0.05), but were directly related with body mass index (r = 0.140, P < 0.05). Discharge disposition locations were not different among groups. Conclusion: Rehabilitation teams can expect comparable gains between obese and non-obese patients following total knee arthroplasty, but at a greater expense.