Percent Body Fat Is More Predictive of Function After Total Joint Arthroplasty Than Body Mass Index

Ledford, Cameron K.; Millikan, Patrick D.; Nickel, Brian T.; Green, Cindy L.; Attarian, David E.; Wellman, Samuel S.; Bolognesi, Michael P.; Queen, Robin M.

doi:10.2106/jbjs.15.00509

Cited by 32 publications

(22 citation statements)

References 41 publications

(31 reference statements)

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“…Obesity is also associated with increased operative time, hospital length of stay, and readmission rates [13], [14]. However, when it comes to patient-reported outcome (PRO) measures, the impact of obesity becomes less clear due to conflicting reports [3], [4], [11], [15], [16] likely reflecting geographic variations, outcome measures used, research methodology, and severity of obesity (all obese patients vs morbidly obese). In addition, most previous studies have focused on TKA, leaving limited information on the effect of obesity on PROs following total hip arthroplasty (THA).…”

Section: Introductionmentioning

confidence: 99%

Effect of morbid obesity on patient-reported outcomes in total joint arthroplasty: a minimum of 1-year follow-up

et al. 2019

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The objective of this study is to explore the effect of morbid obesity on patient-reported outcomes in primary total joint arthroplasty. We retrospectively reviewed 755 primary total joint arthroplasty cases with a minimum of 1-year follow-up. Two groups were compared: (1) patients with BMI < 40 and (2) those with BMI ! 40. The primary outcome was the difference in Short Form-12 physical component summary, Short Form-12 mental component summary, Western Ontario and McMaster Universities Osteoarthritis Index, and patient satisfaction. Multivariate analyses were performed to control for potential confounding factors. 37 patients (5%) were morbidly obese. Morbidly obese patients undergoing total knee arthroplasty had significantly lower net gains in their Short Form-12 physical component summary (P ¼ .008), Short Form-12 mental component summary (P ¼ .049), and Western Ontario and McMaster Universities Osteoarthritis Index (P ¼ .009) in the first 6 months only. For total hip arthroplasty, morbid obesity did not affect any of the outcomes measured (P > .05). There was also no difference in patient satisfaction rates between the two groups (P ¼ .401 and .143 for total hip arthroplasty and total knee arthroplasty, respectively). The impact of morbid obesity on patient-reported outcomes appears to be limited to total knee arthroplasty only in the initial 6 months after surgery.

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Section: Introductionmentioning

confidence: 99%

Effect of morbid obesity on patient-reported outcomes in total joint arthroplasty: a minimum of 1-year follow-up

et al. 2019

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“…Although treatment satisfaction outcomes for a particular modality conducted in Western countries should be extrapolated with caution to Japanese patients due to differences in the outcome measurement methods, outcomes after total knee arthroplasty (TKA) were found to be nearly similar across all the studies. 9 – 11 Predictive factors shown to be associated with TKA satisfaction were higher pre-operative Knee Society Score, 12 low body-fat percentage, 13 and greater pain and disability before surgery. 14 However, no studies have yet been conducted to investigate predictive factors of TSM.…”

Section: Introductionmentioning

confidence: 99%

Treatment satisfaction with pharmaceutical interventions in Japanese adults with osteoarthritis and chronic knee pain: an analysis of a web-based survey

Ueda

Sasaki

Goren

et al. 2018

CIA

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PurposePatient satisfaction is an important outcome in successful osteoarthritis (OA) treatment. The aim of this study was to evaluate treatment satisfaction for medication (TSM) in people with knee OA (KOA), identify the factors predictive of treatment satisfaction, and describe the burden of illness.Patients and methodsThis cross-sectional, patient-reported study used an Internet-based survey and analyzed responses of respondents with KOA (N=400) on characteristics including pain sites and levels (including pain ratings using the Numerical Rating Scale and Short-Form McGill Pain Questionnaire), treatment satisfaction (Global, Effectiveness, and Convenience scores) based on the Treatment Satisfaction Questionnaire for Medication (TSQM-9), and quality of life (QoL; based on the Arthritis Impact Measurement Scale 2-Short Form). Respondents with only KOA (n=237) were compared with those having KOA and additional painful sites (KOA+; n=163). Factors predicting TSM were identified using multivariable linear regression analyses.ResultsRespondents with KOA were more likely to report intermittent pain for 3 months or more compared with those with KOA+ (58.6% vs 48.5%, respectively; P=0.044), while those with KOA+ were more likely to report consistent pain for 3 months or more (P=0.022). Respondents with KOA+ also had more difficulty due to their knee pain while sleeping (P=0.022) and resting (P=0.015). Reported TSM did not differ significantly across KOA vs KOA+ groups, with both groups reporting low satisfaction; all domains of QoL were worse for those with KOA+. Knee pain reduction by medication predicted higher satisfaction across domains, while lower pre-medication pain and post-medication pain matching expectations predicted higher TSQM-9 Global and Effectiveness scores.ConclusionMedication treatment satisfaction rates were low among Japanese respondents with KOA. Given that lower pain, greater pain reduction post-medication, and meeting pain management expectations were predictive of higher satisfaction, treatment strategies that can better address pain may prove beneficial for overall patient satisfaction.

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“…Obesity is usually defined by a high BMI, but a diagnosis depending on body‐ or visceral‐fat percentage has been proposed. A study reported the increase in the amount of body fat to be a superior predictor of the occurrence of some medical complications than the increase in BMI (Ledford et al., 2016).…”

Section: Introductionmentioning

confidence: 99%

Effect of resistance training on quality of life in older people with sarcopenic obesity living in long‐term care institutions: A quasi‐experimental study

Chang

Chiu

2020

Journal of Clinical Nursing

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Aims and objectives To measure the effect of chair resistance training (RT) on the quality of life (QoL) of older long‐term care residents with sarcopenic obesity (SO). Background Sarcopenia combined with obesity, commonly called SO, is considered to be related to health‐related QoL. Despite concerns regarding SO‐related long‐term healthcare issues, intervention studies on SO residents in nursing homes are scant in Taiwan. Design This research was a quasi‐experiment conducted according to the TREND Checklist. A total of 123 older persons were enrolled from six nursing facilities. The RT was implemented between October 2015–March 2016. Method The intervention group received progressive RT with sandbags/dumbbells twice a week for 3 months, whereas the comparison group received the usual care. QoL was the major outcome variable. Data were analysed using chi‐square test, Student's t test and generalised estimating equation (GEE). Results The various definition criteria for SO can influence the results of QoL in the older persons. From the body composition perspective, in the GEE analysis, the SO cut‐off points for neither skeletal muscle mass percentage (SMMp) nor appendicular skeletal muscle mass index demonstrated significant between‐group differences in the QoL variable after the 3‐month RT intervention. Between‐group analysis revealed a significant effect of time on anxiety/depression [Exp(B): 0.41, 95% confidence interval: 0.18–0.93, p‐value < .05] in participants who met all three criteria of the definition of SO (low SMMp, low handgrip strength, and obesity). RT was one of the protective factors. Conclusion In the SO group, the effect of muscle strength on QoL is greater than the effect of changes in body composition after RT. Relevance to clinical practice This study analysed the influence of RT on QoL in subjects with different categories of SO. RT is one of the ways to promote QoL among the SO population. ClinicalTrials.gov Identifier: NCT02912338.

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Percent Body Fat Is More Predictive of Function After Total Joint Arthroplasty Than Body Mass Index

Abstract: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Cited by 32 publications

References 41 publications

Effect of morbid obesity on patient-reported outcomes in total joint arthroplasty: a minimum of 1-year follow-up

Effect of morbid obesity on patient-reported outcomes in total joint arthroplasty: a minimum of 1-year follow-up

Treatment satisfaction with pharmaceutical interventions in Japanese adults with osteoarthritis and chronic knee pain: an analysis of a web-based survey

Effect of resistance training on quality of life in older people with sarcopenic obesity living in long‐term care institutions: A quasi‐experimental study

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