Abstract
BackgroundThere is an existing perception that obesity has a negative impact on complications following total knee arthroplasty (TKA). However, data on the impact of obesity levels on patient-reported outcomes (PROMs) is sparse. We investigated the association between different obesity classes with PROMs among patients who underwent TKA.MethodsWe performed retrospective secondary analyses on data extracted from the total joint replacement data repository (Alberta, Canada) managed by the Alberta Bone and Joint Health Institute (ABJHI). Patients had WOMAC and EQ5D scores measured at baseline in addition to 3 and/or 12 months following TKA. Patients were stratified according to the World Health Organization (WHO) classification, into five body mass index (BMI) groups of normal, overweight, BMI class I, BMI class II, and BMI class III. The association between BMI and mean changes in WOMAC subscales (pain, function, and stiffness) and EQ-5D-5L index over the time intervals of baseline to 3 months and 3 to 12 months following TKA was assessed. Linear mixed-effects models were used, and the models were adjusted for age, sex, length of surgery, comorbidities, year of surgery, and geographical zone where the surgery was performed.ResultsMean age was 65.5 years (SD = 8.7). Postoperatively, there was a significant improvement (p < 0.001) in WOMAC subscales of patient-reported pain, function, and stiffness, as well as EQ-5D-5L regardless of BMI group. Although, patients in BMI class II and class III reported significantly improved pain 3 months after TKA compared to those with normal BMI, all BMI groups attained similar level of pain reduction at 12 months after TKA. The greatest improvement in all WOMAC subscales, as well as EQ5D index, occurred between baseline and 3 months (adjusted p < 0.0001).ConclusionThe findings indicate that patients reported improved pain, function, and stiffness across all BMI groups following TKA. Patients with BMI classified as obese reported similar benefits to those with BMI classified as normal weight. These results may help health care providers to discuss expectations regarding the TKA recovery in terms of pain, function, and quality of life improvements with their TKA candidates.
Highlights
There is an existing perception that obesity has a negative impact on complications following total knee arthroplasty (TKA)
The purpose of the current study was to evaluate the association between body mass index (BMI), categorized according to the World Health Organization (WHO) classification, with Patient-Reported Outcome Measures (PROMs) preoperatively, pre- to 3 months postoperatively, as well as 3 to 12 months after TKA adjusting for putative confounders
In the present study, we evaluated the association between BMI groups, categorized according to WHO classification, with Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and EQ5D preoperatively and at different time intervals
Summary
There is an existing perception that obesity has a negative impact on complications following total knee arthroplasty (TKA). Data on the impact of obesity levels on patient-reported outcomes (PROMs) is sparse. We investigated the association between different obesity classes with PROMs among patients who under‐ went TKA. Patients are typically offered total knee arthroplasty (TKA), which is a well-established and Baghbani‐Naghadehi et al BMC Musculoskeletal Disorders (2022) 23:55 effective intervention for end-stage OA [3]. The overall treatment goal of TKA is to relieve pain, restore loss of function, and improve the health-related quality of life (HRQoL) [4, 5]. Despite the known benefits of TKA on health-related outcomes, some patients experience complications [2, 6] and may receive less benefit than expected. Patients in the higher spectrum of body mass index (BMI) may be at greater risk of poor outcomes after TKA and surgeons are left unsure as to whether TKA is beneficial for patients with higher BMI [7,8,9], especially class III
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