Study: Is there a reasonable BMI criterion for TJA?
A study published in the April 4 issue of The Journal of Bone & Joint Surgery attempts to assess various body mass index (BMI) criteria for total joint arthroplasty (TJA). The authors conducted a retrospective, cohort study of 27,671 TJAs to determine if various BMI eligibility criteria had been enforced, how many short-term complications would have been avoided, how many complication-free surgical procedures would have been denied, and the positive predictive value of BMI eligibility criteria as tests for major complications. They found that with a BMI criterion of ≥40 kg/m 2, 1,148 patients would have been denied a surgical procedure free of major complications, and 83 patients would have avoided a major complication. They write that the positive predictive value of a complication based on a BMI of ≥40 kg/m 2 as a test for major complications was 6.74 percent, while the positive predictive value of a complication using a BMI criterion of ≥30 kg/m 2 was 5.33 percent. “Although the acceptable balance between avoiding complications and providing access to care can be debated,” they write, “such a quantitative assessment helps to inform decisions regarding the advisability of enforcing a BMI criterion for [TJA].”
