Table 3 Literature review for radiographic measure of local adiposity as a predictor for infection following TKA

Lateral radiograph

 Watts, 2016 [27]

116

5 years (mean)

90-day reoperation for wound complication/ infection in morbid obesity

Fat thickness at the midpatella

Fat thickness at the most prominent aspect of tibial tubercle

Fat thickness was associated with a significantly increased risk of reoperation

 Wagner, 2018 [24]

528

NR

SSI

Fat thickness at the midpoint of the patella

Fat thickness was a significant predictor of SSI; BMI was not

 Yu, 2018 [28]

374

1 year

Wound complications @ 1 year minimum

Soft tissue width colinear to a line connecting the superior patella to the superior posterior condyle

Soft tissue width colinear to a line across the tibial plateau

Increased soft tissue envelope size was associated with an increased risk of wound complication; BMI did not have this association

 Gupta, 2019 [12]

494

NR

90-day SSI in non-morbid obesity

Fat thickness at the midpatella

Fat thickness at the most prominent aspect of tibial tubercle

BMI not associated with 90-day SSI, increased patellar fat thickness was protective for developing SSI

Anteroposterior and lateral radiograph

 Shearer, 2020 [19]

4745

NR

PJI @ 1 year

Ratio of the fat at the midpoint of the patella to the length of the patellar articular surface

Ratio of width of the plateau to the width of the leg

BMI was a better predictor of PJI than local adiposity

 Vahedi, 2020 [23]

824

5.7 years (mean)

PJI @ 2 year minimum

Soft tissue thickness from the quad tendon to the skin, 8 cm superior to the joint

Soft tissue thickness from the medial aspect of the tibial plateau to the skin

Increased soft tissue thickness was significantly associated with increased risk of PJI, independent of BMI