Minimally Invasive Total Knee Arthroplasty

To the Editor: In the Clinical Therapeutics article on minimally invasive total knee arthroplasty for osteoarthritis, Leopold (April 23 issue)¹ does not offer advice regarding weight reduction to ideal levels as part of his recommendations for a female patient with a body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) of 26.6. Overweight and obesity are potent risk factors for knee osteoarthritis. They are stronger risk factors for knee osteoarthritis in women than in men. In women, the risk of knee osteoarthritis with weight gain is linear.