Metabolic activity of osteoarthritic knees correlates with BMI

Buchholz, Avery L.; Niesen, Matthew C.; Gausden, Elizabeth B.; Sterken, David G.; Hetzel, Scott; Baum, S; Squire, Matthew W.; Kaplan, Lee D.

doi:10.1016/j.knee.2009.07.012

Cited by 14 publications

(12 citation statements)

References 32 publications

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“…22, 23, 24 Key issues are primarily bone demineralisation, deformity, dysfunction and the associated pain due to these changes in body structures. In this review, we were able to identify three studies that reported dysfunction and/or deformity of bone structure in overweight or obese children who report pain.…”

Section: Resultsmentioning

confidence: 99%

Musculoskeletal pain in overweight and obese children

2013

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This review seeks to provide a current overview of musculoskeletal pain in overweight and obese children. Databases searched were Academic Search Complete, CINAHL, Medline, Proquest Health and Medical Complete, Scopus, Google Scholar, SPORTDiscuss and Trove for studies published between 1 January 2000 and 30 December 2012. We used a broad definition of children within a 3- to 18-year age range. The search strategy included the following terms: obesity, morbid obesity, overweight, pain, musculoskeletal pain, child, adolescent, chronic pain, back pain, lower back pain, knee pain, hip pain, foot pain and pelvic pain. Two authors independently assessed each record, and any disagreement was resolved by the third author. Data were analysed using a narrative thematic approach owing to the heterogeneity of reported outcome measures. Ninety-seven records were initially identified using a variety of terms associated with children, obesity and musculoskeletal pain. Ten studies were included for thematic analysis when predetermined inclusion criteria were applied. Bone deformity and dysfunction, pain reporting and the impact of children being overweight or obese on physical activity, exercise and quality of life were the three themes identified from the literature. Chronic pain, obesity and a reduction in physical functioning and activity may contribute to a cycle of weight gain that affects a child's quality of life. Future studies are required to examine the sequela of overweight and obese children experiencing chronic musculoskeletal pain.

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Section: Resultsmentioning

confidence: 99%

Musculoskeletal pain in overweight and obese children

2013

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“…In the social with an aging population, many knee arthroplasties are performed in patients with advanced age and obesity. [ 15 16 ] Obese patients can have more obesity-related surgical complications (e.g., diabetes mellitus, cardiovascular disease, peripheral vascular disease, and stroke) and lower activity levels,[ 17 ] and have been reported to have slow venous blood flow. Their poor venous valve function can be conducive to the formation of venous thrombus in the lower-limb.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Risk Factors for Lower-limb Deep Venous Thrombosis in Old Patients after Knee Arthroplasty

Kang

Jiang

2015

Chinese Medical Journal

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Background:Deep venous thrombosis (DVT) is a common complication of arthroplasty in old patients. We analyzed risk factors for lower-limb DVT after arthroplasty in patients aged over 70 years to determine controllable risk factors.Methods:This was a retrospective study of 1,025 patients aged >70 years treated with knee arthroplasty at our hospital between January 2009 and December 2013. Of 1,025 patients, 175 had postoperative lower-limb DVT. We compared medical history, body mass index (BMI), ambulatory blood pressure, preoperative and postoperative fasting blood glucose (FBG), preoperative blood total cholesterol, triglyceride, high- and low-density lipoprotein cholesterol, and preoperative homocysteine (Hcy) between thrombus and non-thrombus groups. B-mode ultrasonography was used to detect lower-limb DVT before the operation and 7 days after the operation in all patients. Logistic regression analysis was used to determine risk factors for DVT.Results:Incidence of diabetes (P = 0.014), BMI (P = 0.003), preoperative FBG (P = 0.004), postoperative FBG (P = 0.012), and preoperative Hcy (P < 0.001) were significantly higher in the thrombus group. A significantly greater proportion of patients in the non-thrombus group had early postoperative activity (P < 0.001) and used a foot pump (P < 0.001). Operative duration was significantly longer in the thrombus group (P = 0.012). Within the thrombus group, significantly more patients had bilateral than unilateral knee arthroplasty (P < 0.01). Multivariate logistic analysis revealed BMI, preoperative Hcy, postoperative FBG, long operative duration, bilateral knee arthroplasty, and time to the activity after the operation to be predictive factors of DVT. At 6-month follow-up of the thrombus group, 4.7% of patients had pulmonary embolism and 18.8% had recurrent DVT; there were no deaths.Conclusions:Obesity, inactivity after operation, elevated preoperative Hcy and postoperative FBG, long operative duration, and bilateral knee arthroplasty were risk factors for DVT in patients aged over 70 years.

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“…With the alarming increase in the number of overweight and obese individuals worldwide [1][2][3] as well as the correlation of degenerative joint disease with higher body mass indices, 5,6,[21][22][23] orthopedic surgeons may potentially perform a higher proportion of joint reconstruction procedures on these patients in the future. However, arthroplasties in obese patients may be associated with more complications, more infection rates, and lower implant survivorship.…”

Section: Discussionmentioning

confidence: 99%

Does Obesity Affect the Outcomes of Primary Total Knee Arthroplasty?

et al. 2013

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The purpose of this study was to compare the clinical and radiographic outcomes of primary total knee arthroplasty (TKA) in obese and nonobese patients. A total of 210 knees in 174 obese patients who had a mean body mass index (BMI) of 34 kg/m2 (range, 30 to 39.9 kg/m2) and who had undergone a primary TKA between 2006 and 2010 were reviewed. There were 115 women and 59 men who had a mean age of 62 years (range, 36 to 84 years) and a mean follow-up of 57 months (range, 24 to 82 months). These patients were compared with a group of nonobese patients who had a BMI of less than 30 kg/m2 (range, 19 to 29.9 kg/m2). The evaluated outcomes included implant survivorship, Knee Society objective and functional scores, complication rates, radiographic outcomes, University of California Los Angeles (UCLA) activity score, and the length of hospital stay between obese and nonobese patients. There were no significant differences in the overall septic and aseptic implant survivorship (98.8 vs. 98.6%) and mean postoperative Knee Society objective and function scores (90 and 87 points vs. 91 and 89 points), respectively. Obese patients had significantly higher complication rates (10.5 vs. 3.8%) and had achieved a significantly lower mean postoperative UCLA activity score (5 vs. 6 points). However, there were no differences in the length of hospital stay for the two cohorts. Although the authors encourage all patients to lose weight as much as possible prior to their TKA, it is encouraging that obese patients had achieved excellent clinical outcomes at early to mid-term follow-up.

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Metabolic activity of osteoarthritic knees correlates with BMI

Cited by 14 publications

References 32 publications

Musculoskeletal pain in overweight and obese children

Musculoskeletal pain in overweight and obese children

Analysis of Risk Factors for Lower-limb Deep Venous Thrombosis in Old Patients after Knee Arthroplasty

Does Obesity Affect the Outcomes of Primary Total Knee Arthroplasty?

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