The influence of obesity on functional outcome and quality of life after total knee arthroplasty

2018 ◽  
Vol 100-B (5) ◽  
pp. 579-583 ◽  
Author(s):  
S. Xu ◽  
J. Y. Chen ◽  
N. N. Lo ◽  
S. L. Chia ◽  
D. K. J. Tay ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Functional Outcome ◽  
Knee Arthroplasty ◽  
Obese Group ◽  
Control Group ◽  
Obese Patients ◽  
Knee Score ◽  
Total Knee

AimsThis study investigated the influence of body mass index (BMI) on patients’ function and quality of life ten years after total knee arthroplasty (TKA).Patients and MethodsA total of 126 patients who underwent unilateral TKA in 2006 were prospectively included in this retrospective study. They were categorized into two groups based on BMI: < 30 kg/m2(control) and ≥ 30 kg/m2(obese). Functional outcome was assessed using the Knee Society Function Score (KSFS), Knee Society Knee Score (KSKS), and Oxford Knee Score (OKS). Quality of life was assessed using the Physical (PCS) and Mental Component Scores (MCS) of the 36-Item Short-Form Health Survey.ResultsPatients in the obese group underwent TKA at a younger age (mean, 63.0 years, sd 8.0) compared with the control group (mean, 65.6 years, sd 7.6; p = 0.03). Preoperatively, both groups had comparable functional and quality-of-life scores. Ten years postoperatively, the control group had significantly higher OKS and MCS compared with the obese group (OKS, mean 18 (sd 5) vs mean 22 (sd 10), p = 0.03; MCS, mean 56 (sd 10) vs mean 50 (sd 11), p = 0.01). After applying multiple linear regression with the various outcomes scores as dependent variables and age, gender, and Charlson Comorbidity Index as independent variables, there was a clear association between obesity and poorer outcome in KSFS, OKS, and MCS at ten years postoperatively (p < 0.01 in both KSFS and OKS, and p = 0.03 in MCS). Both groups had a high satisfaction rate (97.8% in the control group vs 87.9% in the obese group, p = 0.11) and fulfillment of expectations at ten years (98.9% in the control group vs 100% in the obese group, p = 0.32).ConclusionAlthough both obese and non-obese patients have significant improvements in function and quality of life postoperatively, obese patients tend to have smaller improvements in the OKS and MCS ten years postoperatively. It is important to counsel patients on the importance of weight management to achieve a more sustained outcome after TKA. Cite this article: Bone Joint J 2018;100-B:579–83.

scholarly journals Assessment of post-surgical pain after the application of ultrasound-guided percutaneous neuromodulation in total knee arthroplasty

2019 ◽  
Vol 02 (02) ◽  
pp. 092-092
Author(s):  
Martín-Macho Martínez M. ◽  
Ventero Gómez A. ◽  
Carrió Font M. ◽  
Martín Buigues A.
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Conventional Treatment ◽  
Control Group ◽  
Ultrasound Guided ◽  
Surgical Pain ◽  
Total Knee ◽  
Experimental Group

Abstract Background and Aim The use of prosthetic knee replacements currently represent an alternative for patients who suffer from severe gonarthrosis. Treatment via the technique of ultrasound-guided percutaneous neuromodulation (US-guided PNM) is a therapeutic alternative worth considering as a new tool in physical therapy for the post-surgical recovery of total knee arthroplasty (TKA). The aim of this study was to evaluate the effectiveness of treatment with US-guided PNM in the post-surgical stage among patients intervened with TKA. Material and Methods Patients were selected between February and May 2017 at the Hospital of Denia and were randomly assigned into two groups. The initial sample was 13 patients. The experimental group (n = 7) received treatment with US-guided PNM plus conventional treatment. The control group (n = 6) only received conventional physiotherapy treatment. Patients in the experimental group received an application of PNM, which consisted of an alternate low frequency current at 10 Hz¸ pulse width 250 μs, with an intensity to the pain threshold. The intervention was performed during four consecutive weeks after hospital discharge. The control group received conventional treatment based on manual therapy, active mobilization and the use of the arthromotor until 115° of knee flexion and 0° knee extension was achieved. The main clinical variables evaluated were pain, measured using the Visual Analog Scale (VAS), quality of life, based on physical and mental components, using the SF12 scale and functional assessment using the Oxford Knee Score. Lastly, pain, stiffness and functional capacity was measured using the WOMAC scale. Results Both groups obtained statistically significant results in the four variables evaluated compared to the pre-surgery stage, however, the changes were more evident in the intervention group (p < 0.05). Furthermore, no significant differences were found in the variables evaluated regarding quality of life between the experimental and control group except for the emotional component of the SF-12 scale, where the result was only significant in the experimental group treated with US-guided PNM (P < 0.05). Regarding the improvement in the health status and decreased pain in the postoperative stage after TKA, no significant differences were observed between groups (p > 0.05). Conclusion The application of the US-guided PNM technique provides greater benefits than conventional therapy for decreasing the post-surgical pain in patients who have undergone knee arthroplasty and for emotional function, evaluated using the SF-12 questionnaire.

scholarly journals Quality of life and functional outcome after single-radius and multi-radius total knee arthroplasty

2018 ◽  
Vol 26 (3) ◽  
pp. 230949901879241 ◽  
Author(s):  
Merrill Lee ◽  
Jerry Yongqiang Chen ◽  
Hao Ying ◽  
Pang Hee Nee ◽  
Darren Keng Jin Tay ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Functional Outcome ◽  
Knee Arthroplasty ◽  
T Test ◽  
Significant Difference ◽  
Patient Groups ◽  
Total Knee ◽  
Single Radius

Purpose: The main objective of this study was to compare quality of life and functional outcome in patients who have undergone a single-radius (SR) or multi-radius (MR) total knee arthroplasty (TKA). The secondary objective was to observe changes in knee range of movement (ROM) and standardized knee scores (KSCs) in these patients. The hypothesis was that there would be no statistically significant difference between the two patient groups in quality of life and functional outcome. Methods: One hundred three SR TKAs were performed by a single surgeon between August 2008 and December 2012. A propensity score matching algorithm was used to select 103 MR TKAs performed during the same period. Preoperative and postoperative variables such as standardized knee and quality of life scores were captured prospectively and then analyzed via both the Student’s t-test and paired t-test to look for statistically significant differences between the SR and MR patient groups. Results: At 2 years postoperatively, there was no statistically significant difference between the SR and MR patient populations in knee extension, Oxford Knee Score, Knee Society Clinical Rating Scores, and the Physical Component Summary of the Short Form 36 Health Survey (SF-36). There was a statistically significant difference between the two patient groups in postoperative knee flexion in favor of the MR design ( p = 0.011). Conclusion: While an SR femoral implant design has several theoretical biomechanical advantages, postoperative standardized KSCs and quality of life scores in this single-surgeon series do not show a clear advantage of one design over the other. Level of evidence: III.

scholarly journals Functional outcome and quality of life in patients with hip fracture after total knee arthroplasty

2019 ◽  
Vol 27 (2) ◽  
pp. 230949901985233
Author(s):  
Don Thong Siang Koh ◽  
Jerry Yongqiang Chen ◽  
Andy Khye Soon Yew ◽  
Hwei Chi Chong ◽  
Ying Hao ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Hip Fracture ◽  
Functional Outcome ◽  
Knee Arthroplasty ◽  
Total Knee

The influence of body mass index on functional outcome and quality of life after total knee arthroplasty

2016 ◽  
Vol 98-B (6) ◽  
pp. 780-785 ◽  
Author(s):  
J. Y. Chen ◽  
N. N. Lo ◽  
H. C. Chong ◽  
H. R. Bin Abd Razak ◽  
H. N. Pang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Body Mass Index ◽  
Total Knee Arthroplasty ◽  
Functional Outcome ◽  
Body Mass ◽  
Knee Arthroplasty ◽  
Total Knee

Functional Outcome and Quality of Life after Patient-Specific Instrumentation in Total Knee Arthroplasty

2015 ◽  
Vol 30 (10) ◽  
pp. 1724-1728 ◽  
Author(s):  
Jerry Yongqiang Chen ◽  
Pak Lin Chin ◽  
Darren Keng Jin Tay ◽  
Shi-Lu Chia ◽  
Ngai Nung Lo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Functional Outcome ◽  
Knee Arthroplasty ◽  
Patient Specific ◽  
Patient Specific Instrumentation ◽  
Total Knee

scholarly journals Is obesity a contraindication for simultaneous bilateral total knee arthroplasty? A prospective case–control study

SICOT-J ◽  
2020 ◽  
Vol 6 ◽  
pp. 42
Author(s):  
Sanjay Agarwala ◽  
Yash Santosh Wagh ◽  
Mayank Vijayvargiya
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Functional Outcomes ◽  
Oxford Knee Score ◽  
Obese Group ◽  
Obese Patients ◽  
Knee Score ◽  
Total Knee ◽  
Simultaneous Bilateral Tka

Aim: Total Knee Arthroplasty (TKA) for decades has been an effective treatment modality for chronic arthritis of the knee. However, there is scarcity of literature comparing the functional outcomes of simultaneous bilateral TKA in obese patients with non-obese Indian population. We conducted this study to evaluate the functional outcomes and complication rates of simultaneous bilateral TKA in obese patients matched control with non-obese patients. Materials and methods: We divided the patients into two study groups based on their body mass index (BMI). Patients with a BMI of less than 30 were classified as non-obese and those with a BMI of more than 30 were classified as obese. All the patients underwent simultaneous bilateral TKA by a single surgeon using the same implant and technique. Patients were followed up regularly and functional outcomes in terms of Oxford knee score were noted at 6 weeks, 3 months, and 1 year. Post-operative complications and time to recovery was also compared. Results: Mean follow-up in obese group was 18 months (12–25 months) and in non-obese group was 17 months (12–24 months). Both the groups were matched with control in terms of pre-operative parameters. Post-operative hemoglobin drop, ICU requirement, length of hospital stay, mean walking time, and mean time to climbing stairs were similar in both the groups. Oxford knee score was significantly better in non-obese group at 6 weeks, but was similar in both the groups at 3 months, 6 months, 1 year, and last follow-up. There was no statistically significant difference seen in the complication rate in both the groups. There was no implant loosening or radiolucency seen. Conclusion: We conclude in our study that simultaneous bilateral TKA gives comparable mid-term results in obese patients in comparison to the non-obese patients.

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