Functional and Radiological Outcomes of Total Knee Arthroplasty in Patients with Advanced Osteoarthritis and Obesity

Abstract

Background: Advanced knee osteoarthritis is a common cause of chronic pain, reduced mobility, and functional disability, particularly in obese individuals. Obesity accelerates the progression of osteoarthritis through increased joint loading and metabolic-inflammatory mechanisms, potentially affecting surgical outcomes after total knee arthroplasty.

Objective: To evaluate the functional and radiological outcomes of total knee arthroplasty in obese patients with advanced knee osteoarthritis.

Methods: This prospective observational study was conducted in the Department of Orthopaedic Surgery, Ghurki Trust Teaching Hospital, Lahore, Pakistan, from June 2024 to October 2025. A total of 100 obese patients aged 45 years and above with advanced knee osteoarthritis undergoing primary total knee arthroplasty were included through non-probability consecutive sampling. Functional outcomes were assessed using pain score, knee function, range of motion, walking ability, stair climbing, and knee stability. Radiological outcomes included implant alignment, prosthesis positioning, deformity correction, and early postoperative complications. Data were analyzed using SPSS version 25.0.

Results: The mean age of the patients was 62.8 ± 8.4 years, and females constituted 64.0% of the study population. The mean body mass index was 33.7 ± 3.1 kg/m². Significant postoperative improvement was observed in all functional parameters. Pain score improved from 8.1 ± 1.0 preoperatively to 2.1 ± 0.9 postoperatively, while functional score increased from 39.6 ± 8.7 to 82.9 ± 9.4. Knee flexion improved from 84.7 ± 13.5° to 112.8 ± 10.6°. Satisfactory implant alignment was achieved in 89.0% of patients, and 90.0% of patients had good to excellent overall outcomes.

Conclusion: Total knee arthroplasty provides significant functional improvement and satisfactory radiological outcomes in obese patients with advanced knee osteoarthritis and remains an effective treatment option in this population.