Obesity increases the likelihood of total joint replacement surgery among younger adults

Harms, Susan; Larson, Riley; Sahmoun, Abe E.; Beal, James

doi:10.1007/s00264-006-0130-y

Cited by 91 publications

(68 citation statements)

References 9 publications

(27 reference statements)

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“…The most common indicator for total joint replacement (TJR) is severe osteoarthritis (OA) (5,6), and TJR is often considered an acceptable surrogate indicator of severe OA (7)(8)(9). Factors associated with OA (e.g., age, female sex, and obesity) are predictors of TJR (7,10).…”

Section: -224]) Adjusting For Deyo-charlson Index or Elixhauser'smentioning

confidence: 99%

Smoking, body weight, physical exercise, and risk of lower limb total joint replacement in a population‐based cohort of men

Mnatzaganian¹,

Ryan²,

Norman³

et al. 2011

Arthritis & Rheumatism

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Objective. To assess the associations of smoking, body weight, and physical activity with risk of undergoing total joint replacement (TJR) in a population-based cohort of men.Methods. A cohort study of 11,388 men that integrated clinical data with hospital morbidity data and mortality records was undertaken. The risk of undergoing TJR was modeled on baseline weight, height, comorbidity, socioeconomic status, years of smoking, and exercise in 3 separate age groups, using Cox proportional hazards regressions and competing risk regressions (CRRs).Results. Dose-response relationships between weight and risk of TJR and between smoking and risk of TJR were observed. Being overweight independently increased the risk of TJR, while smoking lowered the risk. The decreased risk among smokers was demonstrated in both Cox and CRR models and became apparent after 23 years of exposure. Men who were in the highest quartile (>48 years of smoking) were 42-51% less likely to undergo TJR than men who had never smoked. Tests for trend in the log hazard ratios (HRs) across both smoking and weight quantiles yielded significant P values. Vigorous exercise increased the hazard of TJR; however, the association reached statistical significance only in the 70-74-year-old age group (adjusted HR 1.64 [95% confidence interval 1.19-2.24]). Adjusting for Deyo-Charlson Index or Elixhauser's comorbidity measures did not eliminate these associations.Conclusion. Our findings indicate that being overweight and reporting vigorous physical activity increase the risk of TJR. This study is the first to demonstrate a strong inverse dose-response relationship between duration of smoking and risk of TJR. More research is needed to better understand the role of smoking in the pathogenesis of osteoarthritis.

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Section: -224]) Adjusting For Deyo-charlson Index or Elixhauser'smentioning

confidence: 99%

Smoking, body weight, physical exercise, and risk of lower limb total joint replacement in a population‐based cohort of men

Mnatzaganian¹,

Ryan²,

Norman³

et al. 2011

Arthritis & Rheumatism

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“…9,10 As obesity has become pandemic in both developing and developed countries in recent decades, strict patient selection based on weight had not always been possible. Furthermore, some surgeons were reserved in offering UKA to obese patients in fear of the possible complications and adverse outcomes.…”

Section: Introductionmentioning

confidence: 99%

Does obesity influence early outcome of fixed-bearing unicompartmental knee arthroplasty?

Woo

Chen

Lai

et al. 2017

J Orthop Surg (Hong Kong)

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Obesity is a known major contributing risk factor for knee osteoarthritis (OA). It is also believed that obese unicompartmental knee arthroplasty (UKA) patients tend to have poorer outcome and possible early failure. The purpose of this study is to investigate the early outcome of obese UKA patients in a single institution. Patients who underwent fixed bearing medial UKA in between year 2005 and 2010 were included in this study. They were divided into four groups based on Body Mass Index (BMI): 25 kg/m 2 (Control); 25-29.9 kg/m 2 (Overweight); 30-34.9 kg/m 2 (Obese); >35 kg/m 2 (Severely Obese). Functional outcome was assessed using Knee Society Score (KSS), Oxford Knee Score (OKS) and Short-form 36 (SF-36). One-way ANOVA with Bonferroni post-hoc test was used to compare the four groups for quantitative variables. There were 673 patients in this study, no significant difference between the four BMI groups for gender and side of operated knee (p > 0.05). The functional outcome of all four groups at 2 years were comparable (all p > 0.05). At a mean follow up of 5.4 (range 2.5, 8.5) years, 9 revision surgeries (1.3%) were identified. The mean duration from initial surgery to revision surgery was 49 months (Range 6, 90). Patients' pre-operative BMI did not influence the early outcome of UKA patients. However, patients with higher BMI had relatively lower functional score prior to the surgery and tended to be younger. This did not translate to early failure and the functional improvement was similar among all four groups.

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“…Obesity is one comorbidity that not only increases the risk of TJA [7,13,16] but also increases the risk of revision [32], surgical site infection [21,29], dislocation [30], and thromboembolic events [23]. In addition, obesity is associated with a greater likelihood of having bilateral TKAs [24,35].…”

Section: Introductionmentioning

confidence: 99%

Do Patients Lose Weight After Joint Arthroplasty Surgery? A Systematic Review

Inacio

Kritz‐Silverstein

Paxton

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background The ability of patients with a total joint arthroplasty (TJA) to lose weight after surgery has been investigated in a few studies with inconsistent results. Questions/Purposes We asked: (1) What is the quality of evidence of current published literature on postoperative weight trends for patients who have had a TJA? (2) Do patients lose any weight after TJA? (3) Do patients lose a clinically meaningful amount of weight after TJA?Methods We conducted a systematic review of PubMed and the Cochrane Library. Studies were summarized according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement. Studies were reviewed for quality of evidence and limitations according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. Twelve studies were identified, one case-cohort study and 11 case series. Most studies were from single-surgeon or single-hospital series. Five studies included THAs and TKAs, four only THAs, and three only TKAs. We determined study type, level of evidence, inclusion criteria, procedures, proportion of patients who changed weight, body composition assessment, time of composition assessment, statistical analysis performed, and subgroup analysis conducted. Results Owing to the observational nature of the studies and the serious limitations identified, all were considered very low quality according to GRADE criteria. Studies reported 14% to 49% of patients had some weight loss at least 1 year postoperatively. Conclusions We found no conclusive evidence that weight or body composition increases, decreases, or remains the same after TJA.

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Obesity increases the likelihood of total joint replacement surgery among younger adults

Cited by 91 publications

References 9 publications

Smoking, body weight, physical exercise, and risk of lower limb total joint replacement in a population‐based cohort of men

Smoking, body weight, physical exercise, and risk of lower limb total joint replacement in a population‐based cohort of men

Does obesity influence early outcome of fixed-bearing unicompartmental knee arthroplasty?

Do Patients Lose Weight After Joint Arthroplasty Surgery? A Systematic Review

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