Retrospective study of 2,367 patients undergoing primary total hip or knee arthroplasty (THA/TKA) at an ambulatory surgical center. Patients were stratified by BMI groups (normal, overweight, obesity classes I–III including ≥40). Outcomes assessed: early (24h) and 1–90 day complications, perioperative times, PACU course, and pain scores.

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Body Mass Index > 40 Is Not Correlated With Early Complications in Patients Undergoing Primary Total Joint Arthroplasty at an Ambulatory Surgical Center

Retrospective study of 2,367 patients undergoing primary total hip or knee arthroplasty (THA/TKA) at an ambulatory surgical center. Patients were stratified by BMI groups (normal, overweight, obesity classes I–III including ≥40). Outcomes assessed: early (24h) and 1–90 day complications, perioperative times, PACU course, and pain scores.

🧠 Key Points

Complication rates at 24h and 1–90 days were not significantly different across BMI groups, including BMI ≥40.
Operative and pre-op times were longer in higher BMI patients, but PACU discharge was earlier.
Pain scores before discharge were higher in obesity groups, but without increased adverse events.
Estimated blood loss was similar across BMI groups.
Conclusion: With proper preoperative optimization, BMI ≥40 should not be an exclusion criterion for outpatient TJA; outcomes are comparable to lower BMI patients.

The Journal of Arthroplasty (2025)

doi.org/10.1016/j.arth.2025.08.065