Relationship between body mass index and activity in hip or knee arthroplasty patients

McClung, Christian D.; Zahiri, Christopher A.; Higa, Jerilyn K.; Amstutz, Harlan C.; Schmalzried, Thomas P.

doi:10.1002/jor.1100180106

Cited by 144 publications

(67 citation statements)

References 21 publications

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“…Future versions of the IDEEA 1 system will be able to address this topic. The average number of steps taken per day by the patients in our study (6078 ± 3806) represents a 22% increase over averages reported previously (4988 steps per day in 111 patients) [36,52,53,63]. Although this increase is substantial, it does fall within the wide range of activity (395-17,718 steps per day) that has been described in the same studies.…”

Section: Discussionsupporting

confidence: 62%

2009 Marshall Urist Young Investigator Award: How Often Do Patients with High-Flex Total Knee Arthroplasty Use High Flexion?

Huddleston¹,

Scarborough

Goldvasser

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Although high-flexion TKA designs aim to safely accommodate deep flexion, it is unknown how often patients use deep flexion outside the laboratory. We used a validated smart-activity monitor to document the prevalence of knee flexion greater than 90°in 20 consecutive patients (21 knees) who had high-flexion TKAs, at a minimum of 2 years' followup. Patients wore the device continuously for a mean of 35.7 ± 0.5 hours. The 21 knees flexed more than 90°for an average of 10 ± 3.8 minutes (0.5%). Activities performed with flexion greater than 90°w ere, on average, 70% in single-limb stance, 12% moving from sitting to standing, 8% walking, 7% moving from standing to reclining, 2% stepping, 0.9% moving from lying to standing, and 0.1% running. Eight knees flexed greater than 120°for an average of 2.2 minutes (range, 0.2-15 minutes), or 0.1% of the testing time. Activities performed with flexion greater than 120°were, on average, 90% in single-limb stance, 6% moving from sitting to standing, 3% walking, 0.6% moving from standing to reclining, 0.3% stepping, and 0.1% moving from lying to standing. Peak flexion used at any time during testing was, on average, 84%

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Section: Discussionsupporting

confidence: 62%

2009 Marshall Urist Young Investigator Award: How Often Do Patients with High-Flex Total Knee Arthroplasty Use High Flexion?

Huddleston¹,

Scarborough

Goldvasser

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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“…Moreover, step rate in overweight and obese individuals was lower than normal-weight individuals and there was a significant correlation between BMI and step rate (r ¼ À0.093; P ¼ 0.009). Lower BMI in individuals whose step rates are o6000, 33 lower step rate in obese 34 and the negative correlation [33][34][35][36] were also reported in North American.…”

Section: Physical Activity and Obesity M Yoshioka Et Almentioning

confidence: 54%

Long-period accelerometer monitoring shows the role of physical activity in overweight and obesity

et al. 2005

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CONTEXT: Physical activity (PA) plays an important role in obesity. A new accelerometer has been developed to assess total energy expenditure as well as PA. OBJECTIVE: To investigate the association of PA with overweight and obesity in Japanese men and women, a large crosssectional study was performed using a single-axis accelerometer. DESIGN, SETTING AND PARTICIPANTS: Population-based cross-sectional study of Japanese 18-84 y of age. Height, body weight and PA were measured in 400 male and 388 female Japanese volunteers from 1999 to 2000. The outcome measurements were overweight and obesity, which are defined as a body mass index Z25 kg/m 2 . PA was measured for 1 to 4 weeks and was then categorized into three activity levels, which were defined as light, moderate and vigorous PA. RESULTS: Prevalence of overweight and obesity was 22.3%. Number of steps and time spent in moderate and vigorous PA per day were lower in overweight and obese individuals. No difference was found in time spent in light PA. Individuals who are in the 4th and 5th quintile of moderate and vigorous PA showed a significantly lower body mass index. When odd ratios (ORs) of overweight and obesity estimated by logistic regression were used as effect measures, overweight and obesity were negatively associated with vigorous PA (ORs ¼ 0.91). CONCLUSION: These results indicate that overweight and obese individuals have a lower step rate and are spending less time for moderate to vigorous PA. Participation in vigorous PA is an important predictor of overweight and obesity.

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“…The absence of delamination on the articulating surface can be explained by the low contact stresses produced by the highly congruent contact of THRs. Adhesive PE wear thus dominates [26], which, coupled with the multidirectional hip motion, produces polished wear surfaces.…”

Section: Discussionmentioning

confidence: 99%

How Does Wear Rate Compare in Well-functioning Total Hip and Knee Replacements? A Postmortem Polyethylene Liner Study

Pourzal

Knowlton

Hall

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background The longevity of total hip (THR) and knee replacements (TKR) that used historical bearing materials of gamma-in-air sterilized UHMWPE was affected more by osteolysis in THRs than in TKRs, although osteolysis remains a concern in TKRs. Therefore, the study of polyethylene wear is still of interest for the knee, particularly because few studies have investigated volumetric material loss in tibial knee inserts. For this study, a unique collection of autopsy-retrieved TKR and THR components that were well-functioning at the time of retrieval was used to compare volumetric wear differences between hip and knee polyethylene components made from identical material. Questions/purposes The following questions were addressed: (1) How much did the hip liners wear and what wear patterns did they exhibit? (2) How much did the knee inserts wear and what wear patterns did they exhibit? (3) What is the ratio between TKR and THR wear after controlling for implantation time and patient age? Methods We compared 23 THR components (HarrisGalante [HG] and HG II) and 20 TKR components (MillerGalante [MG II]) that were retrieved postmortem. The components were made from the same polyethylene formulation and with similar manufacturing and sterilization (gamma-in-air) processes. Twenty-one patients (12 males, nine females) had THRs and 16 (four males, 12 females) had TKRs. Patients who had TKRs had an older (p = 0.001) average age than patients who had THRs (age, 75 years; SD, 10, versus 66 years; SD, 12, respectively). Only wellfunctioning components were included in this study. Therefore, implants retrieved postmortem from physically active patients and implanted for at least 2 years were considered. In addition, only normally wearing TKR components were considered, ie, those with fatigue wear (delamination) were excluded. The wear volume of each component was measured using metrology. For the tibial inserts an autonomous mathematic reconstruction method was used for quantification. Results The acetabular liners of the THR group had a wear rate of 38 mm 3 per year (95% CI, 29-47 mm 3 /year). Excluding patients with low-activity, the wear rate was 47 mm 3 per year (95% CI, 37-56 mm 3 /year). The wear rate of normally wearing tibial inserts was 17 mm 3 per year (95% CI, À6 to 40 mm 3 /year). After controlling for the relevant confounding variable of age, we found a TKR/THR wear rate ratio of 0.5 (95% CI, 0.29-0.77) at 70 years of age with a slightly increasing difference with increasing age. Conclusions Excluding delamination, TKRs exhibited lower articular wear rates than THRs for historical polyethylene in these two unique cohorts of postmortem retrievals.

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Relationship between body mass index and activity in hip or knee arthroplasty patients

Cited by 144 publications

References 21 publications

2009 Marshall Urist Young Investigator Award: How Often Do Patients with High-Flex Total Knee Arthroplasty Use High Flexion?

2009 Marshall Urist Young Investigator Award: How Often Do Patients with High-Flex Total Knee Arthroplasty Use High Flexion?

Long-period accelerometer monitoring shows the role of physical activity in overweight and obesity

How Does Wear Rate Compare in Well-functioning Total Hip and Knee Replacements? A Postmortem Polyethylene Liner Study

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