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No association between obesity and long-term outcomes of partial knee arthroplasty

Clinical Question:
Do obese patients have worse long-term outcomes than nonobese patients who undergo unicompartmental knee arthroplasty?

Bottom Line:
Although the reporting of this study presents challenges to the validity of the conclusions, it found no association between obesity and orthopedic surgical outcomes, which matches the results of other studies. (LOE = 4)

Reference:
Cavaignac E, Lafontan V, Reina N, et al. Obesity has no adverse effect on the outcome of unicompartmental knee replacement at a minimum follow-up of seven years. Bone Joint J 2013;95-B(8):1064-1068.  [PMID:23908421]

Study Design:
Case series

Funding:
Unknown/not stated

Setting:
Inpatient (any location) with outpatient follow-up

Synopsis:
These authors examined the medical records and contacted patients who had undergone unicompartmental knee arthroplasties at a single center in Toulouse, France. The patients had surgery between 7 years and 22 years (mean = 11.6 years) before the follow-up occurred. Of the 254 total patients, 51 had died and the authors were unable to reach 18 more. Upon contacting the patients (or the family members and physicians, in the case of deceased patients) the authors ascertained whether knee revision surgery had occurred. The main outcome, the Knee Society Score (KSS), is a 100-point composite measure that includes specific stability and range-of-motion assessments of the knee joint, pain, function (maximum score if patients are able to ascend and descend stairs without using a handrail), and use of ambulation assistive devices (eg, canes or walkers). It is not clear if the KSS was exclusively based on data in the medical record or if the authors actually evaluated the patients. At the time of surgery, the patients' mean body mass index (BMI) was 27.9 kg/m^2 and their mean age was 66 years. None of the deceased patients had undergone revisions; 15 of the surviving patients had. Sixty of the patients were obese (BMI = 30 kg/m^2 or greater). The authors found no association between the KSS and obesity. Additionally, the overall 10-year joint survival was 93% and the authors found no difference between obese patients and nonobese patients.

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