The influence of obesity on functional outcomes and patient satisfaction 8 weeks after total knee arthroplasty: results of the prospective FInGK study

Abstract

Objectives To investigate obese versus non-obese subjects´ knee joint function, stiffness, pain, expectations, and outcome satisfaction before and two months after total knee arthroplasty (TKA). Methods This study is a secondary analysis of data retrieved via a prospective single-centre cohort study investigating knee joint function and health care services utilization in patients undergoing TKA (FInGK Study). For the primary study, elective TKA patients were consecutively recruited between December 2019 and May 2021. Preoperative expectations, Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC), surgery outcome satisfaction, and sociodemographic variables were assessed via self-reported questionnaires. In the current study, obese (Body Mass Index (BMI) ≥ 30 kg/m²) versus non-obese (BMI < 30 kg/m²) subjects’ data were exploratively compared before and two months after TKA. Multivariable logistic regression assessed factors associated with TKA satisfaction two months postoperatively. Linear regression evaluated factors associated with higher WOMAC change two months postoperatively. Results A total of 241 subjects participated (response: 85.2%). Eighty-seven were non-obese (mean age: 70.7 years, 63.2% female) and 154 were obese (mean age: 67.1 years, 57.8% female). Obese subjects reported inferior pre- and postoperative pain and knee joint function compared to non-obese subjects. Yet, WOMAC scores of obese and non-obese subjects significantly improved from preoperative means of 52.6 and 46.8 to 32.3 and 24.4 after surgery, respectively. The only significant TKA satisfaction predictor was subjects’ smoking status. Non-obesity and worse preoperative WOMAC scores were predictive of higher WOMAC change scores after two months. Conclusion Both obese and non-obese subjects reported significant symptom improvements. However, as obese subjects’ short-term outcomes were still inferior, more research on TKA rehabilitation measures adapted to the needs of this growing patient group is warranted to maximize their benefits from TKA.

Functional outcomes after Medial Patellofemoral Ligament Reconstruction show inverted J-shaped relation with Body Mass Index

“…Very few studies have investigated the relationship between BMI and the outcomes of MPFL reconstruction. Studies analysing other surgical procedures such as knee arthroplasty has found obesity is associated with lower postoperative outcomes scores [3,19,25], treatment satisfaction and impaired health-related QoL [3,19] The results of this study build upon those reported by Enderlein et al [8], who found that postoperative clinical outcomes of MPFL reconstruction were inferior in patients with a BMI > 30 kg/m 2 . When we analysed the same two BMI groups in our study, we found that surgery gave both groups an almost identical mean improvement of around 23 and 26 points on the Kujala and IKDC scales.…”

“…Very few studies have investigated the relationship between BMI and the outcomes of MPFL reconstruction. Studies analysing other surgical procedures such as knee arthroplasty has found obesity is associated with lower postoperative outcomes scores [3, 19, 25], treatment satisfaction and impaired health‐related QoL [3, 19]…”

Association between Obesity and Short-Term Patient-Reported Outcomes following Total Knee Arthroplasty: A Retrospective Cohort Study in Japan

“…However, the effect of obesity on patient-reported outcomes remains unclear. Although some studies reported no association, others reported either negative or positive associations between obesity and postoperative pain and functional outcomes [ 16 , 18 , 19 , 20 , 23 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ]. Previous studies have mainly focused on mid- to long-term outcomes, with limited evidence on the early recovery phase [ 30 ].…”

“…Although some studies reported no association, others reported either negative or positive associations between obesity and postoperative pain and functional outcomes [ 16 , 18 , 19 , 20 , 23 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ]. Previous studies have mainly focused on mid- to long-term outcomes, with limited evidence on the early recovery phase [ 30 ]. Furthermore, most studies investigating this association have been conducted in Western countries.…”

The influence of body weight index on initial stability of uncemented femoral knee protheses: A finite element study

“…Osteoarthritis is a degenerative disease of the joints that cause joint pain, stiffness, swelling, restricted movement and even joint deformity. Osteoarthritis of the knee is the most common type of osteoarthritis, with 360 million cases worldwide each year [ 1 ]. When knee osteoarthritis progresses to the end stage, total knee arthroplasty (TKA) is an effective and commonly used treatment modality.…”