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Obese Patients Achieve Good Improvements in Patient-Reported Outcome Measures After Medial Unicompartmental Knee Arthroplasty Despite a Lower Preoperative Score
The Journal of Arthroplasty ( IF 3.4 ) Pub Date : 2022-09-10 , DOI: 10.1016/j.arth.2022.09.002
Anders Bagge 1 , Christian B Jensen 1 , Mette Mikkelsen 1 , Kirill Gromov 1 , Christian S Nielsen 1 , Anders Troelsen 1
Affiliation  

In this study, we examined the association between obesity and patient-reported outcome measures after medial unicompartmental knee arthroplasty (MUKA), assessed through score changes, Patient Acceptable Symptom State (PASS), and minimal important change (MIC). Second, the association between obesity and early readmissions was examined. A total of 450 MUKAs (mean body mass index [BMI] 30.3, range, 19.6-53.1), performed from February 2016 to December 2020, were grouped using BMI: <30, 30-34.9, and >34.9. Oxford Knee Score (OKS), Forgotten Joint Score (FJS), and Activity and Participation Questionnaire (APQ) were assessed preoperatively and at 3, 12, and 24 months, postoperatively. The 12-month PASS and MIC were also assessed, defining PASS as OKS = 30, MIC-OKS as change in OKS = 8, and MIC-FJS as change in FJS = 14. No significant differences in OKS change were found between BMI groups. After 12 months, patients who had a BMI of 30-34.9 had lower change in FJS (estimate −8.1, 95% CI −14.9 to −1.4) and were less likely to reach PASS (odds ratio 0.4, 95% CI 0.2-0.7) as well as MIC-FJS (odds ratio 0.5, 95% CI 0.2-0.9). Both obese groups had lower change in APQ after 12 months. Differences in 90-day readmission rates were nonsignificant between groups. Our findings of no differences in OKS improvement between BMI groups and achieving MIC for BMI > 34.9 suggest good improvements in obese patients despite lower preoperative scores, supporting contemporary indications for MUKA. Lower APQ development and achievement of 12-month PASS may be used when addressing expectations of recovery.

中文翻译:

尽管术前评分较低,但肥胖患者在内侧单间室膝关节置换术后,患者报告的结果指标取得了良好的改善

在这项研究中,我们检查了内侧单间室膝关节置换术 (MUKA) 后肥胖与患者报告的结果测量之间的关联,通过评分变化、患者可接受的症状状态 (PASS) 和最小重要变化 (MIC) 进行评估。其次,研究了肥胖与早期再入院之间的关联。 2016 年 2 月至 2020 年 12 月期间进行的总共 450 例 MUKA(平均体重指数 [BMI] 30.3,范围 19.6-53.1)按 BMI 分组:<30、30-34.9 和 >34.9。术前以及术后 3、12 和 24 个月评估牛津膝关节评分 (OKS)、遗忘关节评分 (FJS) 以及活动和参与问卷 (APQ)。还评估了 12 个月的 PASS 和 MIC,将 PASS 定义为 OKS = 30,将 MIC-OKS 定义为 OKS = 8 的变化,将 MIC-FJS 定义为 FJS = 14 的变化。BMI 组之间未发现 OKS 变化存在显着差异。 12 个月后,BMI 为 30-34.9 的患者 FJS 变化较低(估计值 -8.1,95% CI -14.9 至 -1.4),并且达到 PASS 的可能性较小(比值比 0.4,95% CI 0.2-0.7) )以及 MIC-FJS(优势比 0.5,95% CI 0.2-0.9)。 12 个月后,两个肥胖组的 APQ 变化均较低。各组间 90 天再入院率差异不显着。我们发现 BMI 组之间 OKS 改善没有差异,并且 BMI > 34.9 时达到 MIC,这表明肥胖患者尽管术前评分较低,但有良好改善,支持 MUKA 的当代适应症。在满足恢复预期时,可以使用较低的 APQ 发展和 12 个月 PASS 的实现。
更新日期:2022-09-10
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