Abstract
Thanks to modern surgical techniques and implants, traditional exclusion criteria for unicompartmental knee arthroplasty (UKA) are no longer considered contraindications. The aim of this study is to clarify the impact of obesity on functional outcomes and revision rates of UKA. We performed a comprehensive systematic review using PubMed–Medline, Google Scholar and Cochrane Central. Then, we extracted data related to body mass index (BMI), age and follow-up, functional outcome scores and rate of revisions (all-cause, aseptic and septic). Patients were stratified according to BMI into two groups: non-obese (BMI < 30) and obese (BMI ≥ 30). We identified 22 eligible studies, of which 13 were included in the meta-analysis. Patients with a BMI > 30 had a significantly higher likelihood for revision (p = 0.02), while the risk of septic revision was similar (p = 0.79). The clinical outcome measures showed a significant difference in favor of patients with a BMI < 30 (p < 0.0001). The improvements in Oxford Knee Score and Knee Society Score were significant in both obese and non-obese patients, although the latter showed inferior results. The results of this systematic review and meta-analysis show that BMI is not a contraindication to UKA. However, obese patients have a higher risk for aseptic failure and lower improvement in clinical scores compared to non-obese patients.
Highlights
Unicompartmental knee arthroplasty (UKA) is a valid treatment for end-stage knee osteoarthritis (OA), affecting a single femoro-tibial compartment [1]
Our results demonstrate that reducing access to unicompartmental knee replacement (UKR) for patients with a high body mass index (BMI) needs to be critically re-evaluated
Our systematic review and meta-analysis demonstrated that the risk of revision was greater in obese patients (BMI > 30)
Summary
Unicompartmental knee arthroplasty (UKA) is a valid treatment for end-stage knee osteoarthritis (OA), affecting a single femoro-tibial compartment [1]. Some authors have reported that UKA produces more natural knee biomechanics and healing of physiological gait pattern [7], with superior patient-reported clinical and functional outcomes [8,9,10,11]. Despite these advantages, data from national joint registries showed a higher risk or revision in patients undergoing UKA [12]. The aim of this systematic review and meta-analysis is to compare the results of obese and non-obese patients in terms of clinical and functional scores and risk of revision. Our hypothesis is that a higher BMI would be associated with lower functional outcome scores and higher risk of septic and aseptic failures
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
