Patient satisfaction and patient-reported outcomes do not vary by BMI class in total hip arthroplasty.

Autor: Huffman N; Department of Orthopedic Surgery, Cleveland Clinic Foundation, Orthopedic and Rheumatology Institute, Cleveland, OH, 44195, USA., Pasqualini I; Department of Orthopedic Surgery, Cleveland Clinic Foundation, Orthopedic and Rheumatology Institute, Cleveland, OH, 44195, USA., Redfern RE; Clinical Affairs, Zimmer Biomet, Warsaw, IN, 46580, USA., Murray TG; Department of Orthopedic Surgery, Cleveland Clinic Foundation, Orthopedic and Rheumatology Institute, Cleveland, OH, 44195, USA., Deren ME; Department of Orthopedic Surgery, Cleveland Clinic Foundation, Orthopedic and Rheumatology Institute, Cleveland, OH, 44195, USA., Israelite CL; Department of Orthopaedic Surgery, Penn Medicine, Philadelphia, PA, 19104, USA., Nelson CL; Department of Orthopaedic Surgery, Penn Medicine, Philadelphia, PA, 19104, USA., Van Andel D; Clinical Affairs, Zimmer Biomet, Warsaw, IN, 46580, USA., Cholewa JM; Clinical Affairs, Zimmer Biomet, Warsaw, IN, 46580, USA., Anderson MB; Clinical Affairs, Zimmer Biomet, Warsaw, IN, 46580, USA., Klika AK; Department of Orthopedic Surgery, Cleveland Clinic Foundation, Orthopedic and Rheumatology Institute, Cleveland, OH, 44195, USA., McLaughlin JP; Department of Orthopedic Surgery, Cleveland Clinic Foundation, Orthopedic and Rheumatology Institute, Cleveland, OH, 44195, USA., Piuzzi NS; Department of Orthopedic Surgery, Cleveland Clinic Foundation, Orthopedic and Rheumatology Institute, Cleveland, OH, 44195, USA. piuzzin@ccf.org.; Department of Biomedical Engineering, Cleveland Clinic Foundation, Cleveland, OH, 44195, USA. piuzzin@ccf.org.
Jazyk: angličtina
Zdroj: European journal of orthopaedic surgery & traumatology : orthopedie traumatologie [Eur J Orthop Surg Traumatol] 2024 May; Vol. 34 (4), pp. 1979-1985. Date of Electronic Publication: 2024 Mar 15.
DOI: 10.1007/s00590-024-03894-x
Abstrakt: Purpose: Obesity has been identified as a risk factor for postoperative complications in patients undergoing total hip arthroplasty (THA). This study aimed to investigate patient-reported outcomes, pain, and satisfaction as a function of body mass index (BMI) class in patients undergoing THA.
Methods: 1736 patients within a prospective observational study were categorized into BMI classes. Pre- and postoperative Hip disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS JR), satisfaction, and pain scores were compared by BMI class using one-way ANOVA.
Results: Healthy weight patients reported the highest preoperative HOOS JR (56.66 ± 13.35) compared to 45.51 ± 14.45 in Class III subjects. Healthy weight and Class III patients reported the lowest (5.65 ± 2.01) and highest (7.06 ± 1.98, p < 0.0001) preoperative pain, respectively. Changes in HOOS JR scores from baseline suggest larger improvements with increasing BMI class, where Class III patients reported an increase of 33.7 ± 15.6 points at 90 days compared to 26.1 ± 17.1 in healthy weight individuals (p = 0.002). Fewer healthy weight patients achieved the minimal clinically important difference (87.4%) for HOOS JR compared to Class II (96.5%) and III (94.7%) obesity groups at 90 days postoperatively. Changes in satisfaction and pain scores were largest in the Class III patients. Overall, no functional outcomes varied by BMI class postoperatively.
Conclusion: Patients of higher BMI class reported greater improvements following THA. While risk/benefit shared decision-making remains a personalized requirement of THA, this study highlights that utilization of BMI cutoff may not be warranted based on pain and functional improvement.
(© 2024. The Author(s).)
Databáze: MEDLINE
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