Effect of body mass index on short- and medium-term effectiveness of unicompartmental knee arthroplasty_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHENG Chong ¹ ,  LU Weijie ¹ , LI Zhichen ¹ , ZHOU Junjie ² , CHEN Dongfeng ¹ , WU Yingbin ¹

1. Department of Orthopedic Arthrosurgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Guangdong, 510000, P.R.China;
2. Department of Orthopedics, the First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, 650032, P.R.China;

Corresponding?author：

LU Weijie, Email: 13902280296@139.com

Keywords：

Unicompartment knee arthroplasty; anterior medial compartmental osteoarthritis; body mass index; knee joint

DOI：

10.7507/1002-1892.201909143

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Objective To investigate the effect of body mass index (BMI) on the short- and medium-term effectiveness of unicompartmental knee arthroplasty (UKA) in the treatment of anterior medial compartmental osteoarthritis of knee joint.Methods The clinical data of 55 patients (61 knees) with anterior medial compartmental osteoarthritis of knee joint treated with minimally invasive UKA between May 2014 and May 2019 were retrospectively analyzed. According to BMI, the patients were divided into 3 groups: normal body mass group [group A, BMI 18.50-24.99 kg/m², 23 cases (25 knees)], overweight group [group B, BMI 25.00-29.99 kg/m², 23 cases (25 knees)], obesity group [group C, BMI 30.00-39.99 kg/m², 9 cases (11 knees)]. There was no significant difference in gender, age, sides, disease duration, and preoperative American Special Surgery Hospital (HSS) score, pain visual analogue scale (VAS) score, and knee range of motion (ROM) among 3 groups (P>0.05). The operation time, intraoperative dominant blood loss, and the postoperative decreased amount of hemoglobin at 1 week were recorded and compared among 3 groups. The HSS score, VAS score, and ROM were used to evaluate the knee function and pain improvement.Results There was no significant difference in the operation time, the intraoperative dominant blood loss, and the postoperative decreased amount of hemoglobin at 1 week among 3 groups (P>0.05). All the 55 patients were followed up 5-60 months, with an average of 24 months. No complication such as infection, fat embolism, or deep venous thrombosis of lower extremity occurred after operation. The anteroposterior and lateral X-ray films of the knee joint showed that no dislocation or loosening of the prosthesis occurred and the position of the prosthesis was good. At last follow-up, the HSS score, VAS score, and ROM of the 3 groups were significantly improved when compared with preoperative ones (P<0.05); but there was no significant difference among 3 groups (P>0.05).Conclusion For obese and overweight patients with anterior medial compartmental osteoarthritis of the knee joint, the use of minimally invasive UKA can achieve satisfactory short- and medium-term effectiveness, and the long-term effectiveness needs further follow-up.

Citation： ZHENG Chong, LU Weijie, LI Zhichen, ZHOU Junjie, CHEN Dongfeng, WU Yingbin. Effect of body mass index on short- and medium-term effectiveness of unicompartmental knee arthroplasty. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(4): 442-446. doi: 10.7507/1002-1892.201909143 Copy

1.	Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet, 2014, 384(9945): 766-781.
2.	Gillespie GN, Porteous AJ. Obesity and knee arthroplasty. Knee, 2007, 14(2): 81-86.
3.	Anderson JJ, Felson DT. Factors associated with osteoarthritis of the knee in the first national Health and Nutrition Examination Survey (HANES Ⅰ). Evidence for an association with overweight, race, and physical demands of work. Am J Epidemiol, 1988, 128(1): 179-189.
4.	Xia Z, Liow MHL, Goh GS, et al. Body mass index changes after unicompartmental knee arthroplasty do not adversely influence patient outcomes. Knee Surg Sports Traumatol Arthrosc, 2018, 26(6): 1691-1697.
5.	Willis-Owen CA, Brust K, Alsop H, et al. Unicondylar knee arthroplasty in the UK National Health Service: an analysis of candidacy, outcome and cost efficacy. Knee, 2009, 16(6): 473-478.
6.	趙東方, 孔祥朋, 王毅, 等. 第三代 Oxford 單髁假體安放位置對人工單髁關節置換術近期療效的影響. 中國修復重建外科雜志, 2018, 32(12): 1518-1523.
7.	王方興, 薛華明, 馬童, 等. 人工單髁關節置換術治療超高齡膝關節骨關節炎患者的近期療效. 中國修復重建外科雜志, 2019, 33(8): 947-952.
8.	Xing Z, Katz J, Jiranek W. Unicompartmental knee arthroplasty: factors influencing the outcome. J Knee Surg, 2012, 25(5): 369-373.
9.	WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet, 2004, 363(9403): 157-163.
10.	Kozinn SC, Scott R. Unicondylar knee arthroplasty. J Bone Joint Surg (Am), 1989, 71(1): 145-150.
11.	Kandil A, Werner BC, Gwathmey WF, et al. Obesity, morbid obesity and their related medical comorbidities are associated with increased complications and revision rates after unicompartmental knee arthroplasty. J Arthroplasty, 2015, 30(3): 456-460.
12.	Bonutti PM, Goddard MS, Zywiel MG, et al. Outcomes of unicompartmental knee arthroplasty stratified by body mass index. J Arthroplasty, 2011, 26(8): 1149-1153.
13.	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.
14.	van der List JP, Chawla H, Zuiderbaan HA, et al. The role of preoperative patient characteristics on outcomes of unicompartmental knee arthroplasty: A meta-analysis critique. J Arthroplasty, 2016, 31(11): 2617-2627.
15.	王方興, 薛華明, 馬童, 等. 單髁關節置換術治療中重度肥胖膝前內側骨關節炎患者的近期療效分析. 中國骨與關節雜志, 2019, 8(4): 249-254.
16.	Venkatesh HK, Maheswaran SS. Age and body mass index has no adverse effect on clinical outcome of unicompartmental knee replacement-midterm followup study. Indian J Orthop, 2019, 53(3): 442-445.
17.	Woo YL, Chen YQ, Lai MC, et al. Does obesity influence early outcome of fixed-bearing unicompartmental knee arthroplasty? J Orthop Surg (Hong Kong), 2017, 25(1): 2309499016684297.
18.	Xu S, Lim WJ, Chen JY, et al. The influence of obesity on clinical outcomes of fixed-bearing unicompartmental knee arthroplasty: a ten-year follow-up study. Bone Joint J, 2019, 101-B(2): 213-220.
19.	Molloy J, Kennedy J, Jenkins C, et al. Obesity should not be considered a contraindication to medial Oxford UKA: long-term patient-reported outcomes and implant survival in 1000 knees. Knee Surg Sports Traumatol Arthrosc, 2019, 27(7): 2259-2265.

1. Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet, 2014, 384(9945): 766-781.
2. Gillespie GN, Porteous AJ. Obesity and knee arthroplasty. Knee, 2007, 14(2): 81-86.
3. Anderson JJ, Felson DT. Factors associated with osteoarthritis of the knee in the first national Health and Nutrition Examination Survey (HANES Ⅰ). Evidence for an association with overweight, race, and physical demands of work. Am J Epidemiol, 1988, 128(1): 179-189.
4. Xia Z, Liow MHL, Goh GS, et al. Body mass index changes after unicompartmental knee arthroplasty do not adversely influence patient outcomes. Knee Surg Sports Traumatol Arthrosc, 2018, 26(6): 1691-1697.
5. Willis-Owen CA, Brust K, Alsop H, et al. Unicondylar knee arthroplasty in the UK National Health Service: an analysis of candidacy, outcome and cost efficacy. Knee, 2009, 16(6): 473-478.
6. 趙東方, 孔祥朋, 王毅, 等. 第三代 Oxford 單髁假體安放位置對人工單髁關節置換術近期療效的影響. 中國修復重建外科雜志, 2018, 32(12): 1518-1523.
7. 王方興, 薛華明, 馬童, 等. 人工單髁關節置換術治療超高齡膝關節骨關節炎患者的近期療效. 中國修復重建外科雜志, 2019, 33(8): 947-952.
8. Xing Z, Katz J, Jiranek W. Unicompartmental knee arthroplasty: factors influencing the outcome. J Knee Surg, 2012, 25(5): 369-373.
9. WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet, 2004, 363(9403): 157-163.
10. Kozinn SC, Scott R. Unicondylar knee arthroplasty. J Bone Joint Surg (Am), 1989, 71(1): 145-150.
11. Kandil A, Werner BC, Gwathmey WF, et al. Obesity, morbid obesity and their related medical comorbidities are associated with increased complications and revision rates after unicompartmental knee arthroplasty. J Arthroplasty, 2015, 30(3): 456-460.
12. Bonutti PM, Goddard MS, Zywiel MG, et al. Outcomes of unicompartmental knee arthroplasty stratified by body mass index. J Arthroplasty, 2011, 26(8): 1149-1153.
13. 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.
14. van der List JP, Chawla H, Zuiderbaan HA, et al. The role of preoperative patient characteristics on outcomes of unicompartmental knee arthroplasty: A meta-analysis critique. J Arthroplasty, 2016, 31(11): 2617-2627.
15. 王方興, 薛華明, 馬童, 等. 單髁關節置換術治療中重度肥胖膝前內側骨關節炎患者的近期療效分析. 中國骨與關節雜志, 2019, 8(4): 249-254.
16. Venkatesh HK, Maheswaran SS. Age and body mass index has no adverse effect on clinical outcome of unicompartmental knee replacement-midterm followup study. Indian J Orthop, 2019, 53(3): 442-445.
17. Woo YL, Chen YQ, Lai MC, et al. Does obesity influence early outcome of fixed-bearing unicompartmental knee arthroplasty? J Orthop Surg (Hong Kong), 2017, 25(1): 2309499016684297.
18. Xu S, Lim WJ, Chen JY, et al. The influence of obesity on clinical outcomes of fixed-bearing unicompartmental knee arthroplasty: a ten-year follow-up study. Bone Joint J, 2019, 101-B(2): 213-220.
19. Molloy J, Kennedy J, Jenkins C, et al. Obesity should not be considered a contraindication to medial Oxford UKA: long-term patient-reported outcomes and implant survival in 1000 knees. Knee Surg Sports Traumatol Arthrosc, 2019, 27(7): 2259-2265.

Chinese Journal of Reparative and Reconstructive Surgery

Effect of body mass index on short- and medium-term effectiveness of unicompartmental knee arthroplasty

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