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In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty
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Lower Extremity Girth Does Not Predict Complications in TKA.

Eric S Secrist1, Michael D Baratz2, Jacob M Drew3

  • 1Atrium Health - Musculoskeletal Institute, Charlotte, NC.

The Journal of Arthroplasty
|April 23, 2021
PubMed
Summary
This summary is machine-generated.

Leg girth does not predict complications after total knee arthroplasty (TKA). Current eligibility criteria for TKA based on leg size may not accurately identify patients at risk for adverse outcomes.

Keywords:
complicationsobesityrisk stratificationsoft tissue envelopetotal knee arthroplasty

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Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Clinical research

Background:

  • Obesity is linked to increased complications following total knee arthroplasty (TKA).
  • Current TKA eligibility often uses a body mass index (BMI) cutoff of 40, potentially leading to inconsistent patient selection.
  • Patients with high BMI but thin legs, or lower BMI with large legs, may be misclassified regarding surgical risk.

Purpose of the Study:

  • To investigate whether lower extremity girth (LEG) ratio or BMI is a better predictor of 90-day complications after TKA.
  • To evaluate the utility of soft tissue envelope size in predicting TKA outcomes.

Main Methods:

  • A retrospective study included 453 patients who underwent TKA.
  • A lower extremity girth (LEG) ratio was calculated by dividing soft tissue envelope width by bone width on lateral radiographs.
  • Receiver operator curves were used to assess the predictive value of LEG ratio and BMI for complications.

Main Results:

  • No significant difference in median LEG ratio was found between patients with and without complications (P = .08).
  • Receiver operator curves showed that soft tissue envelope size had no predictive utility for TKA complications.
  • Neither LEG ratio nor BMI demonstrated a strong correlation with specific complications like infection or wound issues.

Conclusions:

  • The size of the soft tissue envelope is not a reliable predictor of complications after TKA.
  • TKA eligibility decisions should not rely solely on leg girth measurements.