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Factors Influencing Health-related Quality of Life after TKA in Patients who are Obese

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Although the health-related quality of life (HRQL) for patients who are obese seems to improve after TKA, the magnitude of improvement and the associated factors remain controversial. We previously found body mass index was not associated with changes in HRQL after TKA.

Questions/purposes

The purposes of this secondary analysis were to determine which patient characteristics and surgical factors were associated with worse health status after TKA in patients who are severe or morbidly obese.

Methods

We assessed 60 patients (53 females; mean age, 70 years) 12 months after surgery. The mean number of comorbidities was 2.5. Mean lower limb anthropometric index scores were: suprapatellar, 1.6; infrapatellar, 2; and suprapatellar/infrapatellar, 1.2. Intraoperative difficulty (IOD) was Grade 0, 40%; Grade 1, 48%; and Grade 2, 12%. Ten patients (17%) had complications. We measured HRQL using the disease-specific WOMAC questionnaire. Patient characteristics (sociodemographic variables, BMI, comorbidity, lower limb anthropometry) and surgical factors (IOD, complications, postoperative medical data) were collected. Associations between WOMAC dimension scores at 12 months and patient characteristics and surgical factors were analyzed using linear regression models.

Results

Factors associated with worse WOMAC dimension scores in patients who were obese included the number of comorbidities, an infrapatellar index percentile less than 75, IOD Grade 2, and the number of complications after discharge.

Conclusions

For patients with knee osteoarthritis who were severe or morbidly obese, various lower limb anthropometric features, degree of IOD, and postoperative complications negatively influenced postoperative WOMAC scores.

Level of Evidence

Level II Prognostic Study. See Guidelines for a complete description of levels of evidence.

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Acknowledgments

We thank F. Segura, G. Navarro, and D. Buss for help and advice.

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Authors and Affiliations

  1. Rheumatology, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain

    Montserrat Nuñez PhD

  2. Orthopaedics, Hospital Clinic Barcelona, University of Barcelona, Villarroel 170, 08036, Barcelona, Spain

    Lluis Lozano PhD, Josep-Maria Segur PhD & Sergi Sastre PhD

  3. Institut Català de la Salut, Barcelona, Spain

    Esther Nuñez PhD

Authors
  1. Montserrat Nuñez PhD
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  2. Lluis Lozano PhD
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  3. Esther Nuñez PhD
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  4. Josep-Maria Segur PhD
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  5. Sergi Sastre PhD
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Corresponding author

Correspondence to Sergi Sastre PhD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at: Hospital Clínic, Barcelona (Spain)

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Nuñez, M., Lozano, L., Nuñez, E. et al. Factors Influencing Health-related Quality of Life after TKA in Patients who are Obese. Clin Orthop Relat Res 469, 1148–1153 (2011). https://doi.org/10.1007/s11999-010-1671-3

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  • DOI: https://doi.org/10.1007/s11999-010-1671-3

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