Does the body mass index influence the long-term survival of unicompartmental knee prostheses? A retrospective multi-centre study

Affatato, Saverio; Caputo, Dalila; Bordini, Barbara

doi:10.1007/s00264-018-4217-z

Cited by 25 publications

(24 citation statements)

References 28 publications

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“…Previous studies have focused more on weight as a possible positive or negative predictive factor in UKA. A recent retrospective multi-centre study analysed the data of patients who received unicompartmental knee prosthesis in order to examine if obesity affects clinical outcomes; the conclusion was that obese and morbidly obese patients have as much to gain from total knee replacement as non-obese patients [28]. Sundaram et al, in 2019, assessed the influence of BMI on 30-day postoperative complications after UKA when analysed as both a categorical and continuous variable, highlighting that overweight and obese individuals who undergo UKA may not have an increased risk of 30-day postoperative complications compared with normal-weight individuals [29].…”

Section: Discussionmentioning

confidence: 99%

Return to physical activity and change in body mass index after hypoallergenic medial mobile-bearing unicompartmental knee arthroplasty

et al. 2021

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Background The primary purpose of the present prospective study was to consecutively analyse the outcomes of the return to sports activity of patients with positive patch tests undergoing a medial mobile-bearing titanium niobium nitride (TiNbN) unicompartmental knee arthroplasty (UKA). The secondary purpose was to ascertain if a higher grade of physical activity leads to a reduction in the body mass index (BMI) of the patients. Material and methods Forty-one patients with positive skin patch tests were included in this prospective study. The clinical evaluation consisted of the University of California, Los Angeles (UCLA) activity scale and the High-Activity Arthroplasty Score (HAAS). Each patient was evaluated the day before surgery (T0), after 12.37 ± 0.70 months (T1), and on the day of the final follow-up, after 67.03 ± 18.2 months (T2). Furthermore, the BMI of each patient was analysed before surgery and during the final follow-up. Results The UCLA and HAAS mean preoperative values ranged from 3.68 ± 1.1.7 and 6.15 ± 0.76 to 6.1 ± 0.76 and 10.34 ± 1.3, respectively, at T1 (p < 0.0001) and to the final values of 6.34 ± 0.62 and 11.0 ± 8.9, respectively, at T2 (UCLA: T2 versus T1: p = 0.132; T2 versus T0: p < 0.0001; HAAS: T2 versus T1: p = 0.0027; T2 versus T0: p < 0.001). BMI ranged from a preoperative value of 27.97 ± 3.63 to a final value of 26.84 ± 3.11 (p < 0.0001). The only differences within the subgroups concerned patients with BMI ≥ 28, showing a superior HAAS at each follow-up (p < 0.05). A positive correlation was found between BMI and HAAS at T0 and T2 (p < 0.05). Conclusions This is the first study to evaluate the rate of the return to sports activities and change in BMI following hypoallergenic UKA. The majority of patients reduced their weight following UKA and improved their physical activity, showing outcomes that were comparable to the standard cobalt–chrome (CoCr) prostheses, regardless of gender, age, BMI and implant size. Level of evidence IV – Prospective Cohort Study. Trial registration researchregistry5978—Research Registry www.researchregistry.com

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Section: Discussionmentioning

confidence: 99%

Return to physical activity and change in body mass index after hypoallergenic medial mobile-bearing unicompartmental knee arthroplasty

et al. 2021

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“…When present in the same analysis, only the study with the longest follow-up was considered. Therefore, 22 papers were included in the final systematic review: 12 of these studies were retrospective studies [26][27][28][29][30][31][32][33][34][35][36][37], 5 were prospective studies [38][39][40][41][42] and 5 were case series [25,[43][44][45][46]. Thirteen studies showed adequate information on revisions and functional outcomes to be included in the meta-analysis.…”

Section: Literature Searchmentioning

confidence: 99%

“…Two studies [43,45] only considered patients with BMI > 40 and BMI > 30, respectively. One study [28] divided patients according BMI but did not report the mean BMI of each subgroup. One study [31] did not report the number of procedures, mean age or mean BMI but only the division of patients according to BMI and rate of revision.…”

Section: Patient Demographicsmentioning

confidence: 99%

“…Patient demographics for each study are summarized in Table 1. Eleven studies [25][26][27][28][29][30]33,35,38,39,42] provided mean age, mean BMI and mean follow-up time for all BMI subgroups. Other studies reported mean age, BMI or follow-up time for the whole study population and not for each BMI subgroup.…”

Section: Patient Demographicsmentioning

confidence: 99%

“…Finally, evaluating all the reported clinical outcomes, a significant difference was shown in favor of patients with a BMI < compared to patients with BMI > 30 (MD 4.38, 95% CI, 2.28 to 6.48, p < 0.0001). Moreover, 11 studies [27][28][29]31,33,[38][39][40][41][42]44] analyzed the revisions after UKA and showed a significantly increased likelihood for revision in patients with a BMI > 30 (OR 1.42, 95% CI, 1.05 to 1.92, p = 0.02) (Figure 3). Instead, the rate of septic revisions did not show significant differences between the two groups (OR 0.90, 95% CI, 0.41 to 1.97, p = 0.79) (Figure 4).…”

Section: Effect Of Interventionmentioning

confidence: 99%

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Unicompartmental Knee Replacement in Obese Patients: A Systematic Review and Meta-Analysis

Campi

Papalia

Esposito

et al. 2021

JCM

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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.

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Risk Mitigation for Unicompartmental Knee Arthroplasty

Bohl

Gerlinger

2019

Unicompartmental Knee Arthroplasty

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Does the body mass index influence the long-term survival of unicompartmental knee prostheses? A retrospective multi-centre study

Cited by 25 publications

References 28 publications

Return to physical activity and change in body mass index after hypoallergenic medial mobile-bearing unicompartmental knee arthroplasty

Return to physical activity and change in body mass index after hypoallergenic medial mobile-bearing unicompartmental knee arthroplasty

Unicompartmental Knee Replacement in Obese Patients: A Systematic Review and Meta-Analysis

Risk Mitigation for Unicompartmental Knee Arthroplasty

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