scholarly journals Body Mass Index- and Waist Circumference-Defined Obesity with the risk of Total Knee Arthroplasty for Osteoarthritis: A prospective cohort study 

2020 ◽  
Author(s):  
Yuan Z Lim ◽  
Yuanyuan Wang ◽  
Flavia M Cicuttini ◽  
Graham G Giles ◽  
Stephen Graves ◽  
...  

Abstract Background: There is a discordance in classification of obesity when defined by body mass index (BMI) or waist circumference (WC). We aimed to examine whether categories of BMI- and WC-defined obesity are differentially associated with the risk of total knee arthroplasty for osteoarthritis.Methods: 38,924 participants from the Melbourne Collaborative Cohort Study with BMI and WC measured at baseline (1990-1994) were included. Obesity status was defined as: not obese (non-obese BMI and non-obese WC); WC-defined obesity only (non-obese BMI and obese WC); BMI-defined obesity only (non-obese WC and obese BMI); and BMI- and WC-defined obesity. The incidence of total knee arthroplasty for osteoarthritis between January 2001 and December 2013 was determined by linking participant records to the National Joint Replacement Registry. Results: Over 11.5±3.1 years follow-up, 1,875 participants underwent total knee arthroplasty for osteoarthritis. Participants with WC-defined obesity only (HR=1.79, 95%CI 1.51-2.53), BMI-defined obesity only (HR=2.39, 95%CI 2.02-2.84), and BMI- and WC-defined obesity (HR=3.14, 95%CI 2.82-3.49) had an increased risk of total knee arthroplasty compared with those who were not obese. Conclusions: Individuals with either BMI- or WC-defined obesity should be targeted for prevention of knee osteoarthritis as both are significant predictors for severe osteoarthritis requiring a total knee arthroplasty.

2020 ◽  
Author(s):  
Yuan Z Lim ◽  
Yuanyuan Wang ◽  
Flavia M Cicuttini ◽  
Graham G Giles ◽  
Stephen Graves ◽  
...  

Abstract Background There is a discordance in classification of obesity when defined by body mass index (BMI) or waist circumference (WC). We aimed to examine whether categories of BMI- and WC-defined obesity are differentially associated with the risk of total knee arthroplasty for osteoarthritis. Methods 38,924 participants from the Melbourne Collaborative Cohort Study with BMI and WC measured at baseline (1990-1994) were included. Obesity status was defined as: not obese (non-obese BMI and non-obese WC); WC-defined obesity only (non-obese BMI and obese WC); BMI-defined obesity only (non-obese WC and obese BMI); and BMI- and WC-defined obesity. The incidence of total knee arthroplasty for osteoarthritis between January 2001 and December 2013 was determined by linking participant records to the National Joint Replacement Registry. Results Over 11.5±3.1 years follow-up, 1,875 participants underwent total knee arthroplasty for osteoarthritis. Participants with WC-defined obesity only (HR=1.79, 95%CI 1.51-2.53), BMI-defined obesity only (HR=2.39, 95%CI 2.02-2.84), and BMI- and WC-defined obesity (HR=3.14, 95%CI 2.82-3.49) had an increased risk of total knee arthroplasty compared with those who were not obese. Conclusions Individuals with either BMI- or WC-defined obesity should be targeted for prevention of knee osteoarthritis as both are significant predictors for severe osteoarthritis requiring a total knee arthroplasty.


PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245002
Author(s):  
Yuan Z. Lim ◽  
Yuanyuan Wang ◽  
Flavia M. Cicuttini ◽  
Graham G. Giles ◽  
Stephen Graves ◽  
...  

Objective To examine the risk of total knee arthroplasty (TKA) due to osteoarthritis associated with obesity defined by body mass index (BMI) or waist circumference (WC) and whether there is discordance between these measures in assessing this risk. Methods 36,784 participants from the Melbourne Collaborative Cohort Study with BMI and WC measured at 1990–1994 were included. Obesity was defined by BMI (≥30 kg/m2) or WC (men ≥102cm, women ≥88cm). The incidence of TKA between January 2001 and December 2018 was determined by linking participant records to the National Joint Replacement Registry. Results Over 15.4±4.8 years, 2,683 participants underwent TKA. There were 20.4% participants with BMI-defined obesity, 20.8% with WC-defined obesity, and 73.6% without obesity defined by either BMI or WC. Obesity was classified as non-obese (misclassified obesity) in 11.7% of participants if BMI or WC alone was used to define obesity. BMI-defined obesity (HR 2.69, 95%CI 2.48–2.92), WC-defined obesity (HR 2.28, 95%CI 2.10–2.48), and obesity defined by either BMI or WC (HR 2.53, 95%CI 2.33–2.74) were associated with an increased risk of TKA. Compared with those without obesity, participants with misclassified obesity had an increased risk of TKA (HR 2.06, 95%CI 1.85–2.30). 22.7% of TKA in the community can be attributable to BMI-defined obesity, and a further 3.3% of TKA can be identified if WC was also used to define obesity. Conclusions Both BMI and WC should be used to identify obese individuals who are at risk of TKA for osteoarthritis and should be targeted for prevention and treatment.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
K Giesinger ◽  
JM Giesinger ◽  
DF Hamilton ◽  
J Rechsteiner ◽  
A Ladurner

Abstract Background Total knee arthroplasty is known to successfully alleviate pain and improve function in endstage knee osteoarthritis. However, there is some controversy with regard to the influence of obesity on clinical benefits after TKA. The aim of this study was to investigate the impact of body mass index (BMI) on improvement in pain, function and general health status following total knee arthroplasty (TKA). Methods A single-centre retrospective analysis of primary TKAs performed between 2006 and 2016 was performed. Data were collected preoperatively and 12-month postoperatively using WOMAC score and EQ-5D. Longitudinal score change was compared across the BMI categories identified by the World Health Organization. Results Data from 1565 patients [mean age 69.1, 62.2% women] were accessed. Weight distribution was: 21.2% BMI < 25.0 kg/m2, 36.9% BMI 25.0–29.9 kg/m2, 27.0% BMI 30.0–34.9 kg/m2, 10.2% BMI 35.0–39.9 kg/m2, and 4.6% BMI ≥ 40.0 kg/m2. All outcome measures improved between preoperative and 12-month follow-up (p < 0.001). In pairwise comparisons against normal weight patients, patients with class I-II obesity showed larger improvement on the WOMAC function and total score. For WOMAC pain improvements were larger for all three obesity classes. Conclusions Post-operative improvement in joint-specific outcomes was larger in obese patients compared to normal weight patients. These findings suggest that obese patients may have the greatest benefits from TKA with regard to function and pain relief one year post-op. Well balanced treatment decisions should fully account for both: Higher benefits in terms of pain relief and function as well as increased potential risks and complications. Trial registration This trial has been registered with the ethics committee of Eastern Switzerland (EKOS; Project-ID: EKOS 2020–00,879)


2011 ◽  
Vol 26 (8) ◽  
pp. 1194-1197 ◽  
Author(s):  
Naomi E. Gadinsky ◽  
Jessica K. Ehrhardt ◽  
Christopher Urband ◽  
Geoffrey H. Westrich

2018 ◽  
Vol 26 (3) ◽  
pp. 230949901880242 ◽  
Author(s):  
Usha Gurunathan ◽  
Aaron Pym ◽  
Cameron Anderson ◽  
Amanda Marshall ◽  
Sarah L Whitehouse ◽  
...  

Purpose: To investigate the association between body mass index (BMI) and perioperative complications until hospital discharge, following primary total knee arthroplasty (TKA). Methods: This retrospective study reviewed 1665 cases of elective primary unilateral TKA performed between 2006 and 2010, from a prospective secure electronic database. Types of complications, length of operating time, and duration of hospital stay were analyzed in both adjusted (for known confounders) and unadjusted analyses. A further matched analysis was also performed. Results: In terms of overall complications, there was no statistically significant difference between the BMI categories. When individual obesity category was considered, obese 2 had the lowest odds of developing complications, both with unadjusted (odds ratio (OR): 0.61, 95% confidence interval (CI) 0.41–0.91, p < 0.015) and adjusted regression analysis (OR: 0.65, 95% CI: 0.43–0.99, p = 0.044). Compared to normal weight category, obese class 3 (≥40 kg/m2) individuals were at 66% (OR: 0.34, 95% CI: 0.21–0.55) lower (unadjusted) odds of developing cardiac complications (overall p < 0.001). With the matched analysis, compared to normal weight category, obese class 3 (≥40 kg/m2) individuals were at a 60% (OR: 0.40, 95% CI: 0.23–0.68) lower (unadjusted) odds of developing cardiac complications (overall p = 0.004). Obese 3 patients had significantly higher operating time compared with other groups ( p < 0.001). Conclusion: This study did not find a significant association between BMI and increased overall in-hospital medical or surgical complications following primary TKA. Obesity significantly increased the length of operating time.


Author(s):  
Matthew A. Siegel ◽  
Michael J. Patetta ◽  
Angie M. Fuentes ◽  
Armaan S. Haleem ◽  
Craig W. Forsthoefel ◽  
...  

AbstractKnee range of motion (ROM) is an important postoperative measure of total knee arthroplasty (TKA). There is conflicting literature whether patients who are obese have worse absolute ROM outcomes than patients who are not obese. This study analyzed whether preoperative body mass index (BMI) influences knee ROM after patients' primary TKA. A retrospective investigation was performed on patients, who underwent primary TKA at an academic institution, by one of three fellowship-trained adult reconstruction surgeons. Patients were stratified according to their preoperative BMI into nonobese (BMI < 30.0 kg/m2) and obese (BMI ≥ 30.0 kg/m2) classifications. Passive ROM was assessed preoperatively as well as postoperatively at patients' most recent follow-up visit that was greater than 2 years. Mann–Whitney U tests were performed to determine statistical significance at p-value <0.05 for ROM outcomes. No statistically significant differences were observed when ROM in the nonobese group was compared with ROM in the obese group both preoperatively (105.73 ± 11.58 vs. 104.14 ± 13.58 degrees, p-value = 0.417) and postoperatively (105.83 ± 14.19 vs. 104.49 ± 13.52 degrees, p-value = 0.777). Mean follow-up time for all patients was 4.49 ± 1.92 years. In conclusion, long-term postoperative ROM outcomes were similar between patients who were nonobese and patients who were obese.


2010 ◽  
Vol 20 (03) ◽  
pp. 199-204 ◽  
Author(s):  
Kevin Mulhall ◽  
Hassan Ghomrawi ◽  
William Mihalko ◽  
Quanjun Cui ◽  
Khaled Saleh

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