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DOI: 10.1055/s-0040-1713862
Obesity Does Not Affect Patient-Reported Outcomes following Patellofemoral Arthroplasty
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Abstract
Patellofemoral arthroplasty (PFA) has garnered attention in recent years as an effective alternative to total knee arthroplasty for patients with symptomatic, isolated patellofemoral joint arthritis. Obesity has previously been identified as a risk factor for revision surgery, but its effect on patient-reported outcome measures (PROMs) has not been evaluated. A retrospective review of a consecutive series of PFA surgeries was conducted at a single, specialized orthopedics center in a major urban center. Patients were dichotomized by body mass index (BMI) as obese (O, BMI >30) or nonobese (NO, BMI: 18.5–25). Demographic, surgical information, and PROMs were collected and analyzed accordingly. Seventy-six patients (41 nonobese, 35 obese) were identified. Patients who were obese presented with significantly worse preoperative PROMs regarding knee-specific quality of life, physical function, and MH or mental health (knee injury and osteoarthritis outcome score quality of life [KOOS QoL], NO: 26.2, O: 14.7, p = 0.019; KOOS PF, NO: 38.2, O: 50.5, p = 0.002; Veterans Rand-12 mental health [VR-12 MH], NO: 54.2, O: 47.0, p = 0.033). No significant difference was seen in improvement in knee function scores between patients who were obese or nonobese (KOOS QoL, NO: 39.5, O: 40.6, p = 0.898; KOOS PS [physical function], NO: –17.8, O: –17.3, p = 0.945). Additionally, no difference in the rate of PFA revision was observed and there were no postoperative complications reported. Obese patients with isolated PFA can expect the same improvement in function as nonobese patients following patellofemoral joint arthroplasty. This paper underscores the priority of patient selection in PFA and challenges the notion that surgeons should exclude patients from receiving a PFA on the basis of obesity.
Publikationsverlauf
Eingereicht: 06. Januar 2020
Angenommen: 24. Mai 2020
Artikel online veröffentlicht:
13. Juli 2020
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References
- 1 Mihalko WM, Boachie-Adjei Y, Spang JT, Fulkerson JP, Arendt EA, Saleh KJ. Controversies and techniques in the surgical management of patellofemoral arthritis. Instr Course Lect 2008; 57: 365-380
- 2 Tauro B, Ackroyd CE, Newman JH, Shah NA. The Lubinus patellofemoral arthroplasty. A five- to ten-year prospective study. J Bone Joint Surg Br 2001; 83 (05) 696-701
- 3 Dy CJ, Franco N, Ma Y, Mazumdar M, McCarthy MM, Gonzalez Della Valle A. Complications after patello-femoral versus total knee replacement in the treatment of isolated patello-femoral osteoarthritis. A meta-analysis. Knee Surg Sports Traumatol Arthrosc 2012; 20 (11) 2174-2190
- 4 Nicol SG, Loveridge JM, Weale AE, Ackroyd CE, Newman JH. Arthritis progression after patellofemoral joint replacement. Knee 2006; 13 (04) 290-295
- 5 Farr J, Arendt E, Dahm D, Daynes J. Patellofemoral arthroplasty in the athlete. Clin Sports Med 2014; 33 (03) 547-552
- 6 Liow MHL, Goh GS-H, Tay DK, Chia SL, Lo NN, Yeo SJ. Obesity and the absence of trochlear dysplasia increase the risk of revision in patellofemoral arthroplasty. Knee 2016; 23 (02) 331-337
- 7 van Jonbergen H-PW, Werkman DM, Barnaart LF, van Kampen A. Long-term outcomes of patellofemoral arthroplasty. J Arthroplasty 2010; 25 (07) 1066-1071
- 8 Chaudhry H, Ponnusamy K, Somerville L, McCalden RW, Marsh J, Vasarhelyi EM. Revision rates and functional outcomes among severely, morbidly, and super-obese patients following primary total knee arthroplasty: a systematic review and meta-analysis. JBJS Rev 2019; 7 (07) e9
- 9 Hakim J, Volpin G, Amashah M. et al. Long-term outcome of total knee arthroplasty in patients with morbid obesity. Int Orthop 2020; 44 (Suppl. 01) 95-104
- 10 Ponnusamy KE, Marsh JD, Somerville LE, McCalden RW, Vasarhelyi EM. Ninety-day costs, reoperations, and readmissions for primary total knee arthroplasty patients with varying body mass index levels. J Arthroplasty 2018; 33 (7S): S157-S161
- 11 Kujala UM, Jaakkola LH, Koskinen SK, Taimela S, Hurme M, Nelimarkka O. Scoring of patellofemoral disorders. Arthroscopy 1993; 9 (02) 159-163
- 12 Bennell K, Bartam S, Crossley K, Green S. Outcome measures in patellofemoral pain syndrome: test retest reliability and inter-relationships. Phys Ther Sport 2000; 1 (02) 32-41
- 13 Irrgang JJ, Anderson AF, Boland AL. et al. Development and validation of the international knee documentation committee subjective knee form. Am J Sports Med 2001; 29 (05) 600-613
- 14 Boyce L, Prasad A, Barrett M. et al. The outcomes of total knee arthroplasty in morbidly obese patients: a systematic review of the literature. Arch Orthop Trauma Surg 2019; 139 (04) 553-560
- 15 Gurunathan U, Pym A, Anderson C, Marshall A, Whitehouse SL, Crawford RW. Higher body mass index is not a risk factor for in-hospital adverse outcomes following total knee arthroplasty. J Orthop Surg (Hong Kong) 2018; 26 (03) 2309499018802429
- 16 Tohidi M, Brogly SB, Lajkosz K, Grant HJ, VanDenKerkhof EG, Campbell AR. Ten-year mortality and revision after total knee arthroplasty in morbidly obese patients. J Arthroplasty 2018; 33 (08) 2518-2523
- 17 Steinhaus ME, Buller LT, Romero JA, Lee YY, Figgie MP, McLawhorn AS. Body mass index classification is independently associated with health-related quality of life after primary total knee arthroplasty: an institutional registry-based study. J Knee Surg 2020; 33 (04) 399-409