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The effect of morbid obesity (BMI ≥ 35 kg/m(2)) on functional outcome and complication rate following unicompartmental knee arthroplasty: a case-control study
BACKGROUND: 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. METHODS: One hundred four pa...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6704708/ https://www.ncbi.nlm.nih.gov/pubmed/31439046 http://dx.doi.org/10.1186/s13018-019-1316-5 |
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author | Polat, Ayşe Esin Polat, Barış Gürpınar, Tahsin Çarkçı, Engin Güler, Olcay |
author_facet | Polat, Ayşe Esin Polat, Barış Gürpınar, Tahsin Çarkçı, Engin Güler, Olcay |
author_sort | Polat, Ayşe Esin |
collection | PubMed |
description | BACKGROUND: 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. METHODS: One 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/m(2)), obese (30–34.9 kg/m(2)) and morbidly obese (BMI ≥ 35 kg/m(2)) 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. RESULTS: The 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. CONCLUSIONS: We 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. |
format | Online Article Text |
id | pubmed-6704708 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-67047082019-08-28 The effect of morbid obesity (BMI ≥ 35 kg/m(2)) on functional outcome and complication rate following unicompartmental knee arthroplasty: a case-control study Polat, Ayşe Esin Polat, Barış Gürpınar, Tahsin Çarkçı, Engin Güler, Olcay J Orthop Surg Res Research Article BACKGROUND: 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. METHODS: One 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/m(2)), obese (30–34.9 kg/m(2)) and morbidly obese (BMI ≥ 35 kg/m(2)) 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. RESULTS: The 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. CONCLUSIONS: We 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. BioMed Central 2019-08-22 /pmc/articles/PMC6704708/ /pubmed/31439046 http://dx.doi.org/10.1186/s13018-019-1316-5 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Polat, Ayşe Esin Polat, Barış Gürpınar, Tahsin Çarkçı, Engin Güler, Olcay The effect of morbid obesity (BMI ≥ 35 kg/m(2)) on functional outcome and complication rate following unicompartmental knee arthroplasty: a case-control study |
title | The effect of morbid obesity (BMI ≥ 35 kg/m(2)) on functional outcome and complication rate following unicompartmental knee arthroplasty: a case-control study |
title_full | The effect of morbid obesity (BMI ≥ 35 kg/m(2)) on functional outcome and complication rate following unicompartmental knee arthroplasty: a case-control study |
title_fullStr | The effect of morbid obesity (BMI ≥ 35 kg/m(2)) on functional outcome and complication rate following unicompartmental knee arthroplasty: a case-control study |
title_full_unstemmed | The effect of morbid obesity (BMI ≥ 35 kg/m(2)) on functional outcome and complication rate following unicompartmental knee arthroplasty: a case-control study |
title_short | The effect of morbid obesity (BMI ≥ 35 kg/m(2)) on functional outcome and complication rate following unicompartmental knee arthroplasty: a case-control study |
title_sort | effect of morbid obesity (bmi ≥ 35 kg/m(2)) on functional outcome and complication rate following unicompartmental knee arthroplasty: a case-control study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6704708/ https://www.ncbi.nlm.nih.gov/pubmed/31439046 http://dx.doi.org/10.1186/s13018-019-1316-5 |
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