Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Clin Cases. Sep 6, 2026; 14(25): 125054
Published online Sep 6, 2026. doi: 10.12998/wjcc.125054
Published online Sep 6, 2026. doi: 10.12998/wjcc.125054
Obesity and postoperative opioid utilization after total knee arthroplasty: A propensity-matched analysis
Kevin A Wu, Eric Mai, Christopher S Warburton, Suraj Dhanjani, Anjali Prabhat, Marium Raza, Omri Maayan, Junho Song, Michael Shatkin, Brett L Hayden, Department of Orthopedics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
Ankit Choudhury, Department of Orthopaedic Surgery, Medical College of Wisconsin, Mil
Francesca Docters, Laurel Wong, Icahn School of Medicine at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
Calin S Moucha, Leni and Peter W. May Department of Orthopaedic Surgery, Mount Sinai Medical Center, New York, NY 10029, United States
Author contributions: Wu KA conceived and designed the study and drafted the manuscript; Choudhury A performed the data acquisition, statistical analysis, and assisted with manuscript drafting and editing; Mai E, Warburton CS, Dhanjani S, Docters F, Wong L, Prabhat A, Raza M, Maayan O, Song J and Shatkin M contributed to data interpretation and manuscript revision; Moucha CS and Hayden BL supervised the study and provided critical revision of the manuscript; and all authors read and approved the final manuscript.
AI contribution statement: No artificial intelligence tools were used in the preparation of this manuscript.
Institutional review board statement: This retrospective cohort study used de-identified patient data from a national database and did not require Institutional Review Board approval.
Informed consent statement: This study used de-identified data, did not require IRB approval, and informed consent was not required.
Conflict-of-interest statement: The authors declare no conflict of interest.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement- checklist of items.
Data sharing statement: The data that support the findings of this study are derived from a third-party de-identified electronic health record database and are not publicly available due to data-use restrictions. De-identified data may be available from the corresponding author upon request and subject to database permissions.
Corresponding author: Kevin A Wu, MD, Researcher, Department of Orthopedics, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Pl, New York, NY 10029, United States. kevin.wu2@mountsinai.org
Received: July 7, 2026
Revised: July 31, 2026
Accepted: August 20, 2026
Published online: September 6, 2026
Processing time: 66 Days and 11.1 Hours
Revised: July 31, 2026
Accepted: August 20, 2026
Published online: September 6, 2026
Processing time: 66 Days and 11.1 Hours
Core Tip
Core Tip: This large propensity-matched national cohort study examined how body mass index (BMI) relates to opioid prescribing after primary total knee arthroplasty (TKA) in opioid-naive patients. Patients with obesity (BMI 30 kg/m² or greater) had a modestly higher likelihood of receiving postoperative opioid prescriptions, but greater obesity severity, including morbid obesity (BMI 40 kg/m² or greater), was not associated with more prescriptions. BMI alone may therefore be a limited predictor of postoperative opioid prescribing after TKA, and individualized evaluation of psychosocial and pain-related risk factors may better guide opioid stewardship.