ArticlePloS one2013
Influence of body mass index (BMI) on functional improvements at 3 years following total knee replacement: a retrospective cohort study.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 66 citations in OpenAlex.
- Why are patients dissatisfied following a total knee replacement? A systematic review.International orthopaedics · 2020Pooled it
- No difference in the functional improvements between unilateral and bilateral total knee replacements.BMC musculoskeletal disorders · 2018Trial
- Global mapping of institutional and hospital-based (Level II-IV) arthroplasty registries: a scoping review.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Patients lose weight after a total knee arthroplasty: myth or reality?International orthopaedics · 2022Observational
- Does obesity affect patient-reported outcomes following total knee arthroplasty?BMC musculoskeletal disorders · 2022Article
- A comparative prospective study between stemmed versus an unstemmed tibial component in total knee arthroplasty in obese patients.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2021Article
- Increased survival rate in extension stemmed TKA in obese patients at minimum 2 years follow-up.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Article
- Patient-reported outcome measures (PROMs): can they be used to guide patient-centered care and optimize outcomes in total knee replacement?Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2020Article
- Sex does not clinically influence the functional outcome of total knee arthroplasty but females have a lower rate of satisfaction with pain relief.Knee surgery & related research · 2020Article
- General and Abdominal Obesity as Risk Factors for Late-Life Mobility Limitation After Total Knee or Hip Replacement for Osteoarthritis Among Women.Arthritis care & research · 2018Article
- The impact of variations in input directions according to ISO 14243 on wearing of knee prostheses.PloS one · 2018Article
- Effect of Obesity on Pain and Functional Recovery Following Total Knee Arthroplasty.The Journal of bone and joint surgery. American volume · 2017Article
- The comparison of clinical features and quality of life after total knee replacement.Journal of physical therapy science · 2017Article
- Impact of total knee replacement practice: cost effectiveness analysis of data from the Osteoarthritis Initiative.BMJ (Clinical research ed.) · 2017Article
- Do Stemmed Tibial Components in Total Knee Arthroplasty Improve Outcomes in Patients With Obesity?Clinical orthopaedics and related research · 2017Article
- Hip and knee arthroplasty implants contraindicated in obesity.Annals of the Royal College of Surgeons of England · 2016Article
- The Influence of Obesity on the Outcome of TKR: Can the Impact of Obesity be justified from the Viewpoint of the Overall Health Care System?HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2014Review
- The effects of obesity on functional outcomes after total knee arthroplasty: a prospective cohort study.Canadian journal of surgery. Journal canadien de chirurgieArticle
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe number of patients presenting for total knee replacement who are classified as obese is increasing. The functional benefits of performing TKR in these patients are unclear.
aimTo assess the influence pre-operative body mass index has upon knee specific function, general health status and patient satisfaction at 3 years following total knee replacement.
designRetrospective comparative cohort study using prospectively collected data from an institutional arthroplasty register.
methods1367 patients were assessed using the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and Medical Outcomes Trust Short Form-36 (SF-36) scores supplemented by a validated measure of satisfaction pre-operatively and subsequently at 1,2 and 3 year post-operatively. Comparisons were made by dividing the cohort into 4 groups based on body mass index (BMI) 18.5-25.0 kg/m(2) (n = 253);>25.0-30.0 kg/m(2) (n = 559);>30.0-35.0 kg/m(2) (n = 373);>35.0 kg/m(2) (n = 182).
resultsDespite lower pre-operative, 1 and 3 year WOMAC and SF-36 scores patients with the highest BMIs >35.0 kg/m(2) experienced similar improvements to patients with a 'normal' BMI (18.5-25.0 kg/m(2)) at 1 year (Difference in WOMAC improvement = 0.0 (95%CI -5.2 to 5.2), p = 1.00) and this improvement was sustained at up to 3 years (Difference in 1 year to 3 year improvement = 2.2 (95%CI: -2.1 to 6.5), p = 1.00). This effect was also observed for the SF-36 mental and physical component scores. Despite equivalent functional improvements levels of satisfaction in the >35.0 kg/m(2) group were lower than for any other BMI group (>35.0 kg/m(2) = 84.6% satisfied versus 18.5-5.0 kg/m(2) = 93.3% satisfied,p = 0.01) as was the proportion of patients who stated they would have the operation again (>35.0 kg/m(2) = 69.6% versus 18.5-25.0 kg/m(2) = 82.2%,p = 0.01).
conclusionObese and morbidly obese patients gain as much functional benefit from total knee replacement as patients with lesser body mass indexes. This benefit is maintained for up to 3 years following surgery. However, these patients are less satisfied with their knee replacement and almost a third would not have the operation again.
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