The influence of obesity on clinical outcomes of fixed-bearing unicompartmental knee arthroplasty: a ten-year follow-up study
| Autor: | Darren Tay, Sheng Xu, Ngai Nung Lo, Seng Jin Yeo, Jerry Yongqiang Chen, S. L. Chia, Ying Hao, W-A J Lim |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Reoperation medicine.medical_specialty medicine.medical_treatment Prosthesis Design Survivorship curve medicine Humans Orthopedics and Sports Medicine In patient Obesity Prospective Studies Range of Motion Articular Unicompartmental knee arthroplasty Arthroplasty Replacement Knee Aged business.industry Follow up studies Age Factors Recovery of Function Middle Aged Osteoarthritis Knee medicine.disease Fixed bearing Surgery Prosthesis Failure Treatment Outcome Unicompartmental knee Patient Satisfaction Quality of Life Female business Knee Prosthesis Follow-Up Studies |
| Zdroj: | The bonejoint journal. (2) |
| ISSN: | 2049-4408 |
| Popis: | AimsThe aim of this study was to assess the influence of obesity on the clinical outcomes and survivorship ten years postoperatively in patients who underwent a fixed-bearing unicompartmental knee arthroplasty (UKA).Patients and MethodsWe prospectively followed 184 patients who underwent UKA between 2003 and 2007 for a minimum of ten years. A total of 142 patients with preoperative body mass index (BMI) of < 30 kg/m2were in the control group (32 male, 110 female) and 42 patients with BMI of ≥ 30 kg/m2were in the obese group (five male, 37 female). Pre- and postoperative range of movement (ROM), Knee Society Score (KSS), Oxford Knee Score (OKS), 36-Item Short-Form Health Survey (SF-36), and survivorship were analyzed.ResultsPatients in the obese group underwent UKA at a significantly younger mean age (56.5 years (sd 6.4)) than those in the control group (62.4 years (sd 7.8); p < 0.001). There was no significant difference in preoperative functional scores. However, those in the obese group had a significantly lower ROM (116° (sd 15°) vs 123° (sd 17°); p = 0.003). Both groups achieved significant improvement in outcome scores regardless of BMI, ten years postoperatively. All patients achieved the minimal clinically important difference (MCID) for OKS and KSS. Both groups also had high rates of satisfaction (96.3% in the control group and 97.5% in the obese group) and the fulfilment of expectations (94.9% in the control group and 95.0% in the obese group). Multiple linear regression showed a clear association between obesity and a lower OKS two years postoperatively and Knee Society Function Score (KSFS) ten years postoperatively. After applying propensity matching, obese patients had a significantly lower KSFS, OKS, and physical component score (PCS) ten years postoperatively. Seven patients underwent revision to total knee arthroplasty (TKA), two in the control group and five in the obese group, resulting in a mean rate of survival at ten years of 98.6% and 88.1%, respectively (p = 0.012).ConclusionBoth groups had significant improvements in functional and quality-of-life scores postoperatively. However, obesity was a significant predictor of poorer improvement in clinical outcome and an increased rate of revision ten years postoperatively. |
| Databáze: | OpenAIRE |
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