Body mass index changes after unicompartmental knee arthroplasty do not adversely influence patient outcomes

Xia, Zhilin; Liow, Ming Han Lincoln; Goh, Graham S.; Chong, Hwei Chi; Lo, Ngai Nung; Yeo, Seng Jin

doi:10.1007/s00167-017-4703-7

Cited by 8 publications

(16 citation statements)

References 46 publications

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“…The 17 studies [2,5,7,15,22,23,25,27,31,32,34,37,38,40,43,44,46] provided a total of 43,845 primary UKA patients stratiied by BMI into three groups: non-obese (BMI < 30 kg/ m 2 ); obese (BMI 30 to < 35 kg/m 2 ), and severely obese (BMI > 35 kg/m 2 ). Eleven studies [2,7,22,23,31,32,37,40,43,44,46] included 27,699 non-obese patients; ten studies [2,7,22,23,32,37,40,43,44,46] reported the mean age at surgery (61.5 ± 12.4 years, range, 26.9-70.3); seven reported patient sex (8515 men and 9294 women) and mean post-operative follow-up (6.9 ± 3.8 years, range, 2-12) [15,22,32,37,43,44,46]. The obese patient group (BMI 30 to < 35 kg/m 2 ) included 13,148 patients from 17 studies; 13 studies reported the mean age at surgery (56.2 ± 12.5 years, range, 33.1-68) …”

Section: Patient and Study Characteristicsmentioning

confidence: 99%

Obesity increases the risk of conversion to total knee arthroplasty after unicompartimental knee arthroplasty: a meta-analysis

Vasso¹,

Corona

Gomberg

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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PurposeThe aim of this meta-analysis was to to determine the inluence of obesity on patient outcome and implant survivorship after primary unicompartmental knee arthroplasty (UKA). Methods A PRISMA systematic review was conducted by searching the Medline (PubMed), EMBASE, and Cochrane electronic databases to identify clinical studies investigating the efect of obesity on outcomes after UKA. Data were collected on aspeciically designed extraction form. Methodological quality was assessed using the Methodological Index for Nonrandomized Studies score. Quantitative meta-analysis was carried out using RevMan 5.4 software. Results A total of 17 studies were included; 43,845 primary UKA patients were classiied by their BMI: on-obese (BMI 25 to < 30 kg/m 2 ); obese (BMI 30 to < 35 kg/m 2 ); severely obese (BMI > 35 kg/m 2 ). Pooled analysis showed no statistically signiicant diference in Knee Society Score (KSS) pain in the obese (n.s.) and the severely obese (n.s.) group compared to the non-obese group, while the KSS function score was lower in the severely obese (P = 0.0002) compared to the obese (P = 0.06) and the non-obese group. Postoperative Oxford Knee Score (OKS) was lower in the obese group (P = 0.01) but not in the severely obese group (P = 0.16). Postoperative Range of Motion (ROM) was comparable in the obese and non-obese group (P = 0.16). Implant survival at 10 years follow-up was signiicantly lower in the obese (82.5-95.3%; P < 0.0001) and the severely obese group (87.5-93.8%; P < 0.0001) thanthe non-obese group (83.6-98.6%). Conclusion Obesity and severe obesity were associated with signiicantly higher revision and lower implant survival rates. Obesity did not inluence clinical and most functional outcomes after UKA, whereas KSS function score was signiicantly lower only for the severely obese patient group. Level of Evidence III, meta-analysis.

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Section: Patient and Study Characteristicsmentioning

confidence: 99%

Obesity increases the risk of conversion to total knee arthroplasty after unicompartimental knee arthroplasty: a meta-analysis

Vasso¹,

Corona

Gomberg

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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“…There were no significant differences in functional outcome, QoL or revision rate between the groups. Post-operative BMI changes were not correlated with any outcome scores [30] This study has some limitations. Firstly, the study sample was small; however, a power analysis was accurately performed to gain a significant cohort with strict inclusion criteria.…”

Section: Discussionmentioning

confidence: 77%

Return to physical activity and change in body mass index after hypoallergenic medial mobile-bearing unicompartmental knee arthroplasty

et al. 2021

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Background The primary purpose of the present prospective study was to consecutively analyse the outcomes of the return to sports activity of patients with positive patch tests undergoing a medial mobile-bearing titanium niobium nitride (TiNbN) unicompartmental knee arthroplasty (UKA). The secondary purpose was to ascertain if a higher grade of physical activity leads to a reduction in the body mass index (BMI) of the patients. Material and methods Forty-one patients with positive skin patch tests were included in this prospective study. The clinical evaluation consisted of the University of California, Los Angeles (UCLA) activity scale and the High-Activity Arthroplasty Score (HAAS). Each patient was evaluated the day before surgery (T0), after 12.37 ± 0.70 months (T1), and on the day of the final follow-up, after 67.03 ± 18.2 months (T2). Furthermore, the BMI of each patient was analysed before surgery and during the final follow-up. Results The UCLA and HAAS mean preoperative values ranged from 3.68 ± 1.1.7 and 6.15 ± 0.76 to 6.1 ± 0.76 and 10.34 ± 1.3, respectively, at T1 (p < 0.0001) and to the final values of 6.34 ± 0.62 and 11.0 ± 8.9, respectively, at T2 (UCLA: T2 versus T1: p = 0.132; T2 versus T0: p < 0.0001; HAAS: T2 versus T1: p = 0.0027; T2 versus T0: p < 0.001). BMI ranged from a preoperative value of 27.97 ± 3.63 to a final value of 26.84 ± 3.11 (p < 0.0001). The only differences within the subgroups concerned patients with BMI ≥ 28, showing a superior HAAS at each follow-up (p < 0.05). A positive correlation was found between BMI and HAAS at T0 and T2 (p < 0.05). Conclusions This is the first study to evaluate the rate of the return to sports activities and change in BMI following hypoallergenic UKA. The majority of patients reduced their weight following UKA and improved their physical activity, showing outcomes that were comparable to the standard cobalt–chrome (CoCr) prostheses, regardless of gender, age, BMI and implant size. Level of evidence IV – Prospective Cohort Study. Trial registration researchregistry5978—Research Registry www.researchregistry.com

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“…a more appropriate patient selection has led to renewed interest and a boom of UKA in the last years. Results improved and survival rates of more than 90% after 15 years and 84% after 20 years have been reported [3][4][5][6].The main reason for different outcomes of UKA is discrepancy in ability surgical indications. There has been no consistent conclusion on the in uence of BMI on the survival rate of the prosthesis, and a large number of recent literatures reported that body weight and BMI of patients seemed to be unrelated to the overall revision rate of TKA [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

“…Obesity is a global epidemic and it is estimated that more than 693 million people worldwide have signs of obesity [3]. Obesity increases the mechanical load on the knee joint, and a strong association between obesity and knee osteoarthritis has been reported in the literature [4]. The risk of knee osteoarthritis is almost four times higher in obese men than in non-obese men and ve times higher in obese women [6].…”

Section: Introductionmentioning

confidence: 99%

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Does Body Mass Index affect the outcomes of patients undergoing unicompartmental knee arthroplasty? A retrospective cohort study

Zhao

et al. 2022

Preprint

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Background: Unicompartmental knee arthroplasty（UKA） has become one of the main methods for the treatment of unicompartmental knee osteoarthritis. There is still lack of medium term data on the outcomes of UKA and survival rate of prosthesis in different body mass index (BMI) groups. Objective: we focus on the effectof BMI on the medium clinical outcomes of UKA. Methods: The retrospective study included patients who received UKA at our hospital, between January 1, 2014 to December 31, 2017.All patients All patients underwent surgery of unicompartmental knee arthroplasty. They were divided into three groups according to BMI. normal body mass group [group A, BMI 14.50～24.99 kg/m2, 14 cases (16 knees)], overweight group [group B, BMI 25.00-27.99 kg/m2, 15 cases (17 knees)], obesity group[group C, BMI 28.00-39.99 kg/m2, 16 cases (18 knees)]. There was no significant difference in gender, age, sides, diseaseduration, and preoperative American Special Surgery Hospital (HSS) score, pain visual analogue scale (VAS) score, and knee range of motion (ROM) among 3 groups (P>0.05). The operation time, intraoperative dominant blood loss, and the postoperative decreased amount of hemoglobin at 2 week were recorded and compared among 3 groups. The the Knee Society Score (KSS), the University of California at Los Angeles (UCLA) activity scale，Knee society score ，VAS score, and ROM were evaluated in three groups. Results: Forty-five of 58 eligible patients were included. All the 45 patients were followed up 36-70 months, with an average of 57.55 months. The function of knee joint in all patients was improved and the pain was obviously relieved. Significant differences were found in the knee score, function score and the knee society score between three groups at 70-month follow-up (p<0.05). Conclusions: For normal and overweight patients with anterior medial compartmental osteoarthritis of the knee joint, the use of minimally invasive UKA can achieve satisfactory short- and medium-term effectiveness. However, this procedure should be chosen carefully with overweight patients.

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Body mass index changes after unicompartmental knee arthroplasty do not adversely influence patient outcomes

Abstract: Level III.

Cited by 8 publications

References 46 publications

Obesity increases the risk of conversion to total knee arthroplasty after unicompartimental knee arthroplasty: a meta-analysis

Obesity increases the risk of conversion to total knee arthroplasty after unicompartimental knee arthroplasty: a meta-analysis

Return to physical activity and change in body mass index after hypoallergenic medial mobile-bearing unicompartmental knee arthroplasty

Does Body Mass Index affect the outcomes of patients undergoing unicompartmental knee arthroplasty? A retrospective cohort study

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