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The influence of obesity on clinical outcomes of fixed-bearing unicompartmental knee arthroplasty: a ten-year follow-up study.
Bone Joint J. 2019 02; 101-B(2):213-220.BJ

Abstract

AIMS

The 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 METHODS

We 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/m2 were in the control group (32 male, 110 female) and 42 patients with BMI of ≥ 30 kg/m2 were 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.

RESULTS

Patients 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).

CONCLUSION

Both 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.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.Health Service Research Unit, Singapore General Hospital, Singapore.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30700121

Citation

Xu, S, et al. "The Influence of Obesity On Clinical Outcomes of Fixed-bearing Unicompartmental Knee Arthroplasty: a Ten-year Follow-up Study." The Bone & Joint Journal, vol. 101-B, no. 2, 2019, pp. 213-220.
Xu S, Lim WJ, Chen JY, et al. The influence of obesity on clinical outcomes of fixed-bearing unicompartmental knee arthroplasty: a ten-year follow-up study. Bone Joint J. 2019;101-B(2):213-220.
Xu, S., Lim, W. J., Chen, J. Y., Lo, N. N., Chia, S. L., Tay, D. K. J., Hao, Y., & Yeo, S. J. (2019). The influence of obesity on clinical outcomes of fixed-bearing unicompartmental knee arthroplasty: a ten-year follow-up study. The Bone & Joint Journal, 101-B(2), 213-220. https://doi.org/10.1302/0301-620X.101B2.BJJ-2018-0969.R2
Xu S, et al. The Influence of Obesity On Clinical Outcomes of Fixed-bearing Unicompartmental Knee Arthroplasty: a Ten-year Follow-up Study. Bone Joint J. 2019;101-B(2):213-220. PubMed PMID: 30700121.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The influence of obesity on clinical outcomes of fixed-bearing unicompartmental knee arthroplasty: a ten-year follow-up study. AU - Xu,S, AU - Lim,W-A J, AU - Chen,J Y, AU - Lo,N N, AU - Chia,S-L, AU - Tay,D K J, AU - Hao,Y, AU - Yeo,S J, PY - 2019/2/1/entrez PY - 2019/2/1/pubmed PY - 2019/2/1/medline KW - Functional outcome KW - Obesity KW - Outcome KW - Quality of life KW - Revision KW - Survivorship KW - Unicompartmental knee arthroplasty SP - 213 EP - 220 JF - The bone & joint journal JO - Bone Joint J VL - 101-B IS - 2 N2 - AIMS: The 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 METHODS: We 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/m2 were in the control group (32 male, 110 female) and 42 patients with BMI of ≥ 30 kg/m2 were 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. RESULTS: Patients 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). CONCLUSION: Both 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. SN - 2049-4408 UR - https://www.unboundmedicine.com/medline/citation/30700121/The_influence_of_obesity_on_clinical_outcomes_of_fixed_bearing_unicompartmental_knee_arthroplasty:_a_ten_year_follow_up_study_ L2 - https://online.boneandjoint.org.uk/doi/full/10.1302/0301-620X.101B2.BJJ-2018-0969.R2?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -