Severe other joint disease and obesity independently influence recovery after joint replacement surgery: an observational study

Naylor, Justine; Harmer, Alison R.; Heard, Rob

doi:10.1016/s0004-9514(08)70067-9

Cited by 47 publications

(53 citation statements)

References 23 publications

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“…Several recent studies [9,10,14,27] have examined the impact of obesity on function of TKA (Table 5). Although some authors reported no differences in the function between nonobese and obese patients during short-term and long-term followups [9,27], others have reported that severely obese patients had poorer function [10,18]. Unlike Spicer et al [24] who reported poorer preoperative scores with obese patients, our patients had similar preoperative outcome scores, the only exception being that the severely obese patients had poorer ROM.…”

Section: Discussioncontrasting

confidence: 45%

Obesity Does Not Imply Poor Outcomes in Asians after Total Knee Arthroplasty

Razak

Chong

Tan

2013

Clinical Orthopaedics &Amp; Related Research

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Background In Asia, obesity has reached epidemic proportions and physicians are likely to face a burden of obesity-related disorders, of which osteoarthritis of the knee is one. However, it is unclear whether obesity affects improvement of conventional TKAs in Asian patients. Purpose We therefore asked whether obese patients with a BMI of 30 kg/m 2 or greater would have worse ROM and function after TKA compared with their nonobese counterparts and whether they would have less improvement preoperatively to postoperatively. Methods

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Section: Discussioncontrasting

confidence: 45%

Obesity Does Not Imply Poor Outcomes in Asians after Total Knee Arthroplasty

Razak

Chong

Tan

2013

Clinical Orthopaedics &Amp; Related Research

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“…Obesity is associated with poor short-term locomotor outcome following a TKR (13,14). Naylor et al evaluated mobility recovery within 1 year post-TKR and observed that obese patients walked more slowly during the 15-meter walk test and required more time to complete the TUG test compared with nonobese patients at 12 weeks and 26 weeks post-TKR (14).…”

Section: Discussionmentioning

confidence: 99%

“…Naylor et al evaluated mobility recovery within 1 year post-TKR and observed that obese patients walked more slowly during the 15-meter walk test and required more time to complete the TUG test compared with nonobese patients at 12 weeks and 26 weeks post-TKR (14). J€ arvenp€ a€ a et al showed that obesity was associated with poorer recovery in knee range of motion and reported that obese patients presented with more pain at 3 months post-TKR compared with nonobese patients (13).…”

Section: Discussionmentioning

confidence: 99%

“…However, the relationship between obesity and post-TKR outcome has not been fully elucidated. Previous studies have shown that a high BMI is associated with the risk of TKR failure, with regard to both clinical outcome and quality-of-life indicators (12)(13)(14)(15). However, other studies have shown that BMI is not associated with post-TKR outcomes (16,17).…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have demonstrated that early rehabilitation following TKR surgery can improve functional mobility, including walking and stair climbing, regardless of the training protocols used (20)(21)(22)(23)(24). However, obesity is associated with limited recovery in functional activities within a short-term followup period (13)(14)(15), and whether BMI influences early mobility outcomes following post-TKR rehabilitation remains unclear. Vincent and Vincent reported that obesity was associated with poor early-discharge outcomes following inpatient post-TKR rehabilitation (25).…”

Section: Introductionmentioning

confidence: 99%

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Body Mass Index and Functional Mobility Outcome Following Early Rehabilitation After a Total Knee Replacement: A Retrospective Study in Taiwan

Liao

Huang

et al. 2015

Arthritis Care & Research

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ObjectiveObesity is associated with an increased risk of osteoarthritis, and the incidence of obese patients requiring a total knee replacement (TKR) has increased in recent years. A high body mass index (BMI) may influence post‐TKR rehabilitation outcomes. We investigated the effects of obesity on functional mobility outcomes following post‐TKR rehabilitation in Asian patients whose BMIs were not as high as those reported in similar studies performed in non‐Asian countries.MethodsA total of 113 patients were categorized as normal weight (n = 23), overweight (n = 32), class I obese (n = 31), or class II/III obese (n = 27). Patients were retrospectively followed up for 6 months after undergoing TKR followed by 2 months of active rehabilitation. Outcome measures were recorded at baseline and at the 2‐month and 6‐month followup assessments and included the Western Ontario and McMaster Universities Osteoarthritis Index and the following tests: functional reach, single‐leg stance, ten‐meter walk, timed up and go, chair rise, and stair climbing.ResultsA 4 × 3 (group × time) repeated‐measures analysis of variance showed significant improvement in all of the outcome measures for all of the BMI groups at the 2‐month and 6‐month followup assessments (P < 0.05 for all). No significant intergroup differences at the 2‐month and 6‐month followup assessments were observed for any of the mobility measures except the functional reach and single‐leg stance (P < 0.05).ConclusionPatients with class II/III obesity benefit from early post‐TKR outpatient rehabilitation and respond as well as patients with lower BMIs.

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Sex Differences and Impact of Body Mass Index on the Time Course of Knee Range of Motion, Knee Strength, and Gait Speed After Total Knee Arthroplasty

Pua

Seah

Seet

et al. 2015

Arthritis Care & Research

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Objective. Quadriceps strength deficits and gait speed limitations remain significant issues after total knee arthroplasty (TKA), yet detailed longitudinal data characterizing these measures and their predictors are limited. This study aimed to describe the time course of knee range of motion, quadriceps strength, and gait speed post-TKA, and to assess whether sex and body mass index (BMI) influenced the time recovery of these measures. Methods. A total of 1,025 patients (mean 6 SD age 67 6 8 years) undergoing primary TKA participated. At 4-, 8-, 12-, and 16-weeks postsurgery, knee range of motion, quadriceps strength, and gait speed were quantified. The associations of the knee and gait measures profile over time with sex and BMI were assessed using generalized least squares modeling. Results. The various knee and gait measures improved nonlinearly over time, with substantial improvements observed in the first 8-10 weeks postsurgery. Sex and BMI influenced the time course of quadriceps strength (P < 0.001 for all interactions): improvements in quadriceps strength over time were slower in women and in patients with higher BMI. Post-TKA gait speed was consistently lower in women than in men, while BMI was negatively and nonlinearly related to gait speed. Conclusion. Although the various knee and gait measures improved over time, women and patients with higher BMI had poorer functional outcomes. The present study highlights the need for a mechanistic understanding of the results and targeted management of these patient subgroups.

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Severe other joint disease and obesity independently influence recovery after joint replacement surgery: an observational study

Abstract: Severe other joint disease and obesity are associated with poorer recovery after surgery. Clinician and patient expectations, rehabilitation, and benchmarking can be guided by these findings.

Cited by 47 publications

References 23 publications

Obesity Does Not Imply Poor Outcomes in Asians after Total Knee Arthroplasty

Obesity Does Not Imply Poor Outcomes in Asians after Total Knee Arthroplasty

Body Mass Index and Functional Mobility Outcome Following Early Rehabilitation After a Total Knee Replacement: A Retrospective Study in Taiwan

Sex Differences and Impact of Body Mass Index on the Time Course of Knee Range of Motion, Knee Strength, and Gait Speed After Total Knee Arthroplasty

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