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Research Article
Fatemeh Baghbani-Nagadehi
University of Alberta
Corresponding Author
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Background: Obesity is a common risk factor for the onset and progression of osteoarthritis (OA). There is also an existing perception that obesity has a negative impact on clinical outcomes following total knee arthroplasty (TKA). We investigated the association between different obesity classes with patient-reported outcomes among patients who underwent TKA.
Methods: We performed retrospective secondary analyses on data extracted from Alberta, Canada, total joint replacement data repository. Patients who underwent primary unilateral TKA between 2012–2016 and who completed the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index (N = 7,714), and the patient reported EuroQol-5D (EQ-5D; N = 3,848) were included in the study. Patients had WOMAC and EQ5D scores measured at baseline in addition to 3 and/or 12 months following TKA. Patients were stratified into five body mass index (BMI) groups of normal, overweight, BMI class I, BMI class II, and BMI class III. The association between BMI and mean changes in WOMAC subscales (pain, function, and stiffness) and EQ-5D-5L index over the time intervals of baseline to 3 months or 3 to 12 months was assessed using linear mixed-effects models that were adjusted for age, sex, length of surgery, comorbidities, and zone of the service.
Results: Mean age was 65.5 years (SD = 8.7). Postoperatively, there was a significant improvement (p < 0.001) in WOMAC subscales of patient-reported pain, function, and stiffness, as well as EQ-5D-5L regardless of BMI group. Although, patients in BMI class II and class III reported significantly improved pain 3 months after TKA compared to those with normal BMI, all BMI groups attained similar level of pain reduction at 12 months. The greatest improvement in all WOMAC subscales, as well as EQ5D index, occurred between baseline and 3 months (adjusted p < 0.0001).
Conclusion: The findings indicate that patients reported improved pain, function, and stiffness across all BMI groups following TKA. Patients with BMI classified as obese reported similar benefits to those with BMI classified as normal weight. These results may help health care providers to discuss expectations regarding the TKA recovery in terms of pain, function, and quality of life improvements with their TKA candidates.
Keywords
Obesity, Total knee arthroplasty, Osteoarthritis, Pain, Function, Quality of life
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No competing interests reported.
This is a list of supplementary files associated with this preprint. Click to download.
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CURRENT STATUS: Published
View the published article at BMC Musculoskeletal Disorders.
Version 1
Posted 13 May, 2021
No community comments so far
Editorial decision: Major revision
On 09 Aug, 2021
Reviewers agreed
On 01 Jul, 2021
Reviews received
Received 28 Jun, 2021
Reviewers agreed
On 26 May, 2021
Reviewers invited
Invitations sent on 12 May, 2021
Editor assigned
On 12 May, 2021
Editor invited
On 12 May, 2021
Submission checks complete
On 12 May, 2021
First submitted
On 05 May, 2021
Metrics
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Subject Areas
Orthopedics
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Musculoskeletal Disorders.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Fatemeh Baghbani-Nagadehi
University of Alberta
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Musculoskeletal Disorders.
Version 1
Posted 13 May, 2021
No community comments so far
Editorial decision: Major revision
On 09 Aug, 2021
Reviewers agreed
On 01 Jul, 2021
Reviews received
Received 28 Jun, 2021
Reviewers agreed
On 26 May, 2021
Reviewers invited
Invitations sent on 12 May, 2021
Editor assigned
On 12 May, 2021
Editor invited
On 12 May, 2021
Submission checks complete
On 12 May, 2021
First submitted
On 05 May, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedics
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Musculoskeletal Disorders.
Background: Obesity is a common risk factor for the onset and progression of osteoarthritis (OA). There is also an existing perception that obesity has a negative impact on clinical outcomes following total knee arthroplasty (TKA). We investigated the association between different obesity classes with patient-reported outcomes among patients who underwent TKA.
Methods: We performed retrospective secondary analyses on data extracted from Alberta, Canada, total joint replacement data repository. Patients who underwent primary unilateral TKA between 2012–2016 and who completed the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index (N = 7,714), and the patient reported EuroQol-5D (EQ-5D; N = 3,848) were included in the study. Patients had WOMAC and EQ5D scores measured at baseline in addition to 3 and/or 12 months following TKA. Patients were stratified into five body mass index (BMI) groups of normal, overweight, BMI class I, BMI class II, and BMI class III. The association between BMI and mean changes in WOMAC subscales (pain, function, and stiffness) and EQ-5D-5L index over the time intervals of baseline to 3 months or 3 to 12 months was assessed using linear mixed-effects models that were adjusted for age, sex, length of surgery, comorbidities, and zone of the service.
Results: Mean age was 65.5 years (SD = 8.7). Postoperatively, there was a significant improvement (p < 0.001) in WOMAC subscales of patient-reported pain, function, and stiffness, as well as EQ-5D-5L regardless of BMI group. Although, patients in BMI class II and class III reported significantly improved pain 3 months after TKA compared to those with normal BMI, all BMI groups attained similar level of pain reduction at 12 months. The greatest improvement in all WOMAC subscales, as well as EQ5D index, occurred between baseline and 3 months (adjusted p < 0.0001).
Conclusion: The findings indicate that patients reported improved pain, function, and stiffness across all BMI groups following TKA. Patients with BMI classified as obese reported similar benefits to those with BMI classified as normal weight. These results may help health care providers to discuss expectations regarding the TKA recovery in terms of pain, function, and quality of life improvements with their TKA candidates.
Figure 1
Figure 2
No competing interests reported.
This is a list of supplementary files associated with this preprint. Click to download.
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