Abstract
BackgroundThe aim of this study was to evaluate and compare the functional outcomes and complication rates of patients in short-term and midterm follow-up period when medial unicompartmental knee arthroplasty (UKA)-applied patients were grouped according to BMI values.MethodsOne hundred four patients (mean age 60.2 ± 7.4 (range, 49–80)) to whom medial UKA was applied between 2011 to 2016 with a minimum of 2 years follow-up were grouped as normal and overweight (less than 30 kg/m2), obese (30–34.9 kg/m2) and morbidly obese (BMI ≥ 35 kg/m2) according to their BMI. The postoperative Knee Society Scores (KSS), functional Knee Society Scores (fKSS), Oxford Knee Scores (OKS), visual analogue scale (VAS) and range of motion (ROM) results and complication rate of these groups were compared statistically. The implant positioning of the patients requiring revision was analysed according to the Oxford radiological criteria.ResultsThe average BMI of 104 patients was 34.4 (range, 22–56.9). Twenty-six (25%) of these were normal or overweight, 40 (38.5%) were obese and 38 (36.5%) were morbidly obese. However, in these BMI groups, there was no significant difference between the preoperative VAS, postoperative VAS and VAS score changes among these three groups (p > 0.05). The postop KSS, f KSS and OKS were significantly poorer in the morbidly obese group by 75.2, 70.5 and 33.1, respectively. Furthermore, amount of ROM changes (4.2°) were significantly poorer in the morbidly obese group (p < 0.05). Complications including eminence fractures, insert dislocations, tibial component collapses and superficial infections developed in 10 patients (9.6%). Six of them (60%) were morbidly obese, and four of them (40%) were obese. Furthermore, 11 (10.6%) of the patients required revision. Eight (72.7%) of the patients were morbidly obese, and three (27.3%) of them were obese.ConclusionsWe concluded that morbid obesity is an independent risk factor for functional outcomes and implant survival after UKA. However, it is possible to obtain excellent results for obese and overweight patients with good planning and correct surgical technique. Morbid obese patients should be preoperatively informed about poor functional outcome and high complication rate. Treatment of morbid obesity before UKA surgery may be a good option.
Highlights
The aim of this study was to evaluate and compare the functional outcomes and complication rates of patients in short-term and midterm follow-up period when medial unicompartmental knee arthroplasty (UKA)-applied patients were grouped according to body mass index (BMI) values
When a body mass index (BMI) between 25 and 29.9 is considered overweight and 30 to 34.9 is obese, it has been shown that the risk of osteoarthritis of the knee increases almost fivefold (4.78) in obese men and almost fourfold (3.87) in obese women; an increase of 1.69-fold in overweight men and 1.89-fold in overweight women was observed [3]
The prevalence of revision frequency is higher than that of total knee arthroplasty (TKA) [5] and the possibility of the opposite compartment going to arthrosis limits the preference of surgeons regarding UKA, faster recovery, less hospitalization time and reduced costs lead many surgeons to view it as an alternative surgical method instead of TKA [5, 6]
Summary
The aim of this study was to evaluate and compare the functional outcomes and complication rates of patients in short-term and midterm follow-up period when medial unicompartmental knee arthroplasty (UKA)-applied patients were grouped according to BMI values. The prevalence of revision frequency is higher than that of TKA [5] and the possibility of the opposite compartment going to arthrosis limits the preference of surgeons regarding UKA, faster recovery, less hospitalization time and reduced costs lead many surgeons to view it as an alternative surgical method instead of TKA [5, 6]. Fatal complications such as infections, thromboembolism and amputation are rarely seen in UKA compared to TKA [7]. The minimally invasive incision reduces postoperative blood loss and pain, while better functional results, as well as rapid and early rehabilitation, are the other advantages of UKA [5, 6]
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