Increased BMI Associated with 30-Day Postoperative Complications Following Total Knee Arthroplasty for Periarticular Fractures Among Geriatric Patients

Due to frequent failure of osteosynthesis after fracture fixation among the elderly, total knee arthroplasty (TKA) is emerging as a viable alternative. The purpose of this study was to determine incidence rates and risk factors for early adverse events following TKA for periarticular knee fractures among geriatrics. Query of the 2010 – 2019 American College of Surgeons’ National Surgical Quality Improvement Program (ACS-NSQIP) databases yielded 154 geriatric patients (> 65 years) managed with TKA for periarticular knee fractures. Patient demographics, comorbidities, and 30-day complications were collected. Most patients were female (n = 141, 92%), with BMI 30.5 ± 9.5 kg/m² and age 78 ± 7.6 years. Most common adverse events were readmissions (n = 13, 8.4%) and pulmonary embolisms (n = 5, 3.2%). Multivariate analysis revealed that only increased BMI (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.01 – 1.11) was independently associated with adverse events. Given that rates of geriatric patients with obesity presenting with periarticular knee fractures are rising, this association may be increasingly useful in informing surgical planning and decision-making. (Journal of Surgical Orthopaedic Advances 35(1):038 – 040, 2026)

Key words: total knee arthroplasty, periarticular knee fracture, geriatric, NSQIP, TKA