Obesity, Orthopaedics, and Outcomes

Mihalko, William M.; Bergin, Patrick F.; Kelly, Frank B.; Canale, S. Terry

doi:10.5435/jaaos-22-11-683

Cited by 71 publications

(46 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A 2012 study by Sabin et al [24] was the first to demonstrate implicit and explicit "anti-fat" bias among a large cohort of medical professionals that was inline with the attitude of the general population. Obese patients, especially women, are reluctant to be weighed by a physician, and studies show that their apprehension is not unfounded, as male physicians are more likely to display weight bias, especially toward their female patients [21]. In a field dominated by male physicians, there is likely significance to the apprehension of the overweight, female orthopedic patient that could inpart explain the delayed presentation seen in our results and throughout the literature.…”

Section: Discussionmentioning

confidence: 59%

“…Although the NHDS only tracks short-term in-hospital outcomes, the gender differences in these measures are still significant. We identified obesity as a potential source of physician gender bias against prospective female patients, as elevated body mass index (BMI) has been extensively correlated with the prevalence of OA [19][20][21][22], and the subsequent need for TKA, with obese (BMI >30) and morbidly obese (BMI >40) patients being 8.5 and 32.7 times more likely to undergo TKA, respectively [23]. These data combined with the greater prevalence of OA in females in general can help explain the greater size of our female cohort as well as potentially help explain female underutilization of TKA due to negative physician attitudes.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Gender Role in Total Knee Arthroplasty: A Retrospective Analysis of Perioperative Outcomes in US Patients

Whitlock

Piponov

Shah

et al. 2016

The Journal of Arthroplasty

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Gender Role in Total Knee Arthroplasty: A Retrospective Analysis of Perioperative Outcomes in US Patients

Whitlock

Piponov

Shah

et al. 2016

The Journal of Arthroplasty

View full text Add to dashboard Cite

“…Obesity is associated with a variety of co‐morbidities and chronic diseases . The systemic metabolic implications of obesity include chronic‐low level inflammation, which may affect the integrity and function of tissues, and may lead to complications after orthopedic surgery . Muscle is a vulnerable tissue in a chronic low‐level inflammatory environment as it is highly plastic and undergoes regular remodeling .…”

mentioning

confidence: 99%

High‐fat high‐sucrose diet leads to dynamic structural and inflammatory alterations in the rat vastus lateralis muscle

Collins

Hart

Reimer

et al. 2016

Journal Orthopaedic Research

View full text Add to dashboard Cite

The influence of obesity on muscle integrity is not well understood. The purpose of this study was to quantify structural and molecular changes in the rat vastus lateralis (VL) muscle as a function of a 12-week obesity induction period and a subsequent adaptation period (additional 16-weeks). Male Sprague-Dawley rats consumed a high-fat, high-sucrose (DIO, n = 40) diet, or a chow control-diet (n = 14). At 12-weeks, DIO rats were grouped as prone (DIO-P, top 33% of weight change) or resistant (DIO-R, bottom 33%). Animals were euthanized at 12- or 28-weeks on the diet. At sacrifice, body composition was determined and VL muscles were collected. Intramuscular fat, fibrosis, and CD68+ cells were quantified histologically and relevant molecular markers were evaluated using RT-qPCR. At 12- and 28-weeks post-obesity induction, DIO-P rats had more mass and body fat than DIO-R and chow rats (p < 0.05). DIO-P and DIO-R rats had similar losses in muscle mass, which were greater than those in chow rats (p < 0.05). mRNA levels for MAFbx/atrogin-1 were reduced in DIO-P and DIO-R rats at 12- and 28-weeks compared to chow rats (p < 0.05), while expression of MuRF1 was similar to chow values. DIO-P rats demonstrated increased mRNA levels for pro-inflammatory mediators, inflammatory cells, and fibrosis compared to DIO-R and chow animals, despite having similar levels of intramuscular fat. The down-regulation of MAFbx/atrogin-1 may suggest onset of degenerative changes in VL muscle integrity of obese rats. DIO-R animals exhibited fewer inflammatory changes compared to DIO-P animals, suggesting a protective effect of obesity resistance on local inflammation. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:2069-2078, 2016.

show abstract

“…Excess weight-bearing may inadvertently cause musculoskeletal disorders, such as fractures, weight-bearing intolerance and lower extremity long bone misalignment. Severe orthopedic complications include Blount disease, slipped capital femoral epiphysis, osteoarthritis, etc [14]. To the contrary, obesity increases bone density, through the association of increased fatty tissue with increased concentrations of bone minerals in the spine and extremities [15].…”

Section: Complications Of Obesitymentioning

confidence: 99%

Childhood Obesity and Its Associations with Morbidity and Mortality in Adult Life

Kakleas¹,

Soldatou²,

Kyriaki³

2018

Diabetes Complications

View full text Add to dashboard Cite

Childhood and adulthood obesity has reached epidemic levels. Unfortunately, obesity tracks from childhood into adulthood and its persistence rises with age among obese children. Childhood obesity is associated with comorbidities, which are present even in childhood, including hypertension, endothelial dysfunction, insulin resistance and type 2 diabetes (T2D), fatty liver disease, obstructive sleep apnea and endocrine, musculoskeletal and psychosocial problems. Early onset obesity is a risk factor for morbidity and mortality later in life. The main causes of death of obese children and adolescents in adulthood include cardiovascular diseases, T2D and its complications, obstructive sleep apnea and cancer. Morbidity and mortality increase proportionately to the severity and duration of childhood obesity. Furthermore, body mass index (BMI) is associated with projected life expectancy. Decreased life expectancy is observed among obese, but also among lean individuals, with the best life expectancy being observed among normal weight and overweight people. Life expectancy has halted at present and further decrease due to the obesity epidemic is expected, if proper measures are not taken. The association between childhood obesity and adult morbidity and mortality strongly suggests that more effective prevention and treatment of childhood obesity should be pursued.

show abstract

Obesity, Orthopaedics, and Outcomes

Cited by 71 publications

References 45 publications

Gender Role in Total Knee Arthroplasty: A Retrospective Analysis of Perioperative Outcomes in US Patients

Gender Role in Total Knee Arthroplasty: A Retrospective Analysis of Perioperative Outcomes in US Patients

High‐fat high‐sucrose diet leads to dynamic structural and inflammatory alterations in the rat vastus lateralis muscle

Childhood Obesity and Its Associations with Morbidity and Mortality in Adult Life

Contact Info

Product

Resources

About