Patient-reported outcome metrics following total knee arthroplasty are influenced differently by patients' body mass index

Johannes M Giesinger; Fanny Loth; Deborah MacDonald; Karlmeinrad Giesinger; James T Patton; Hamish Simpson; Colin R Howie; David Hamilton

doi:10.1007/s00167-018-4853-2

Patient-reported outcome metrics following total knee arthroplasty are influenced differently by patients' body mass index

Johannes M Giesinger, Fanny Loth, Deborah MacDonald, Karlmeinrad Giesinger, James T Patton, Hamish Simpson, Colin R Howie, David Hamilton

Research output: Contribution to journal › Article › peer-review

Abstract

Purpose This study investigated the impact of body mass index (BMI) on improvement in patient outcomes (pain, function, joint awareness, general health and satisfaction) following total knee arthroplasty (TKA).

Methods Data were obtained for primary TKAs performed at a single centre over a 12-month period. Data were collected pre-operatively and 12-month postoperatively with the Oxford Knee Score (OKS) measuring pain and function, the EQ-5D-3L measuring general health status, the Forgotten Joint Score-12 (FJS-12) measuring joint awareness and a single question on treatment satisfaction. Change in scores following surgery was compared across the BMI categories identified by the World Health Organization (<25.0, 25.0-29.9, 30.0-34.9, 35.0-39.9 and >= 40.0). Differences in postoperative improvement between the BMI groups were analysed with an overall Kruskal-Wallis test, with post hoc pairwise comparisons between BMI groups with Mann-Whitney tests.

Results Of 402 patients [mean age 70.7 (SD 9.2); 55.2% women] 15.7% were normal weight (BMI <25.0), 33.1% were overweight (BMI 25.0-29.9), 28.2% had class I obesity (BMI 30.0-34.9), 16.2% had class II obesity (BMI 35.0-39.9), and 7.0% had class III obesity (BMI >= 40.0). Postoperative change in OKS (n.s.) and EQ-5D-3L (n.s.) was not associated with BMI. Higher BMI group was associated with less improvement in FJS-12 scores (p = 0.010), reflecting a greater awareness of the operated joint during activity in the most obese patients. Treatment satisfaction was associated with BMI category (p = 0.029), with obese patients reporting less satisfaction.

Conclusions In TKA patients, outcome parameters are influenced differently by BMI. Our study showed a negative impact of BMI on postoperative improvement in joint awareness and satisfaction scores, but there was no influence on pain, function or general health scores. This information may be useful in terms of setting expectations expectation in obese patients planning to undergo TKA.

Original language	English
Pages (from-to)	3257-3264
Number of pages	8
Journal	Knee Surgery, Sports Traumatology, Arthroscopy
Volume	26
Issue number	11
Early online date	7 Feb 2018
DOIs	https://doi.org/10.1007/s00167-018-4853-2
Publication status	Published - Nov 2018

Keywords / Materials (for Non-textual outputs)

Total knee arthroplasty
Obesity
Patient-reported outcome
Forgotten joint score-12
Oxford Knee Score
FORGOTTEN JOINT SCORE
QUALITY-OF-LIFE
TOTAL HIP
OBESE-PATIENTS
REPLACEMENT
WEIGHT
RELIABILITY
VALIDITY
OSTEOARTHRITIS
VALIDATION

Access to Document

10.1007/s00167-018-4853-2

10.1007%2Fs00167-018-4853-2
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Final published version, 981 KBLicence: Creative Commons: Attribution (CC-BY)

reSTARt - Edinburgh Royal Infirmary Arthroplasty Outcomes Database
Simpson, H. (Principal Investigator)
Non-EU industry, commerce and public corporations
1/01/15 → 31/03/20
Project: Research
EORD: Edinburgh Orthopaedic Research Database Ethics Reference 16/SS/0026
MacDonald, D. (Co-investigator), Howie, C. (Principal Investigator) & Simpson, H. (Principal Investigator)
1/08/02 → 31/12/24
Project: Research

Cite this

@article{a18999d47ec84b00a328757e4bcadc63,

title = "Patient-reported outcome metrics following total knee arthroplasty are influenced differently by patients' body mass index",

abstract = "Purpose This study investigated the impact of body mass index (BMI) on improvement in patient outcomes (pain, function, joint awareness, general health and satisfaction) following total knee arthroplasty (TKA).Methods Data were obtained for primary TKAs performed at a single centre over a 12-month period. Data were collected pre-operatively and 12-month postoperatively with the Oxford Knee Score (OKS) measuring pain and function, the EQ-5D-3L measuring general health status, the Forgotten Joint Score-12 (FJS-12) measuring joint awareness and a single question on treatment satisfaction. Change in scores following surgery was compared across the BMI categories identified by the World Health Organization (<25.0, 25.0-29.9, 30.0-34.9, 35.0-39.9 and >= 40.0). Differences in postoperative improvement between the BMI groups were analysed with an overall Kruskal-Wallis test, with post hoc pairwise comparisons between BMI groups with Mann-Whitney tests.Results Of 402 patients [mean age 70.7 (SD 9.2); 55.2% women] 15.7% were normal weight (BMI <25.0), 33.1% were overweight (BMI 25.0-29.9), 28.2% had class I obesity (BMI 30.0-34.9), 16.2% had class II obesity (BMI 35.0-39.9), and 7.0% had class III obesity (BMI >= 40.0). Postoperative change in OKS (n.s.) and EQ-5D-3L (n.s.) was not associated with BMI. Higher BMI group was associated with less improvement in FJS-12 scores (p = 0.010), reflecting a greater awareness of the operated joint during activity in the most obese patients. Treatment satisfaction was associated with BMI category (p = 0.029), with obese patients reporting less satisfaction.Conclusions In TKA patients, outcome parameters are influenced differently by BMI. Our study showed a negative impact of BMI on postoperative improvement in joint awareness and satisfaction scores, but there was no influence on pain, function or general health scores. This information may be useful in terms of setting expectations expectation in obese patients planning to undergo TKA.",

keywords = "Total knee arthroplasty, Obesity, Patient-reported outcome, Forgotten joint score-12, Oxford Knee Score, FORGOTTEN JOINT SCORE, QUALITY-OF-LIFE, TOTAL HIP, OBESE-PATIENTS, REPLACEMENT, WEIGHT, RELIABILITY, VALIDITY, OSTEOARTHRITIS, VALIDATION",

author = "Giesinger, {Johannes M} and Fanny Loth and Deborah MacDonald and Karlmeinrad Giesinger and Patton, {James T} and Hamish Simpson and Howie, {Colin R} and David Hamilton",

year = "2018",

month = nov,

doi = "10.1007/s00167-018-4853-2",

language = "English",

volume = "26",

pages = "3257--3264",

journal = "Knee Surgery, Sports Traumatology, Arthroscopy",

issn = "0942-2056",

publisher = "Wiley",

number = "11",

}

TY - JOUR

T1 - Patient-reported outcome metrics following total knee arthroplasty are influenced differently by patients' body mass index

AU - Giesinger, Johannes M

AU - Loth, Fanny

AU - MacDonald, Deborah

AU - Giesinger, Karlmeinrad

AU - Patton, James T

AU - Simpson, Hamish

AU - Howie, Colin R

AU - Hamilton, David

PY - 2018/11

Y1 - 2018/11

N2 - Purpose This study investigated the impact of body mass index (BMI) on improvement in patient outcomes (pain, function, joint awareness, general health and satisfaction) following total knee arthroplasty (TKA).Methods Data were obtained for primary TKAs performed at a single centre over a 12-month period. Data were collected pre-operatively and 12-month postoperatively with the Oxford Knee Score (OKS) measuring pain and function, the EQ-5D-3L measuring general health status, the Forgotten Joint Score-12 (FJS-12) measuring joint awareness and a single question on treatment satisfaction. Change in scores following surgery was compared across the BMI categories identified by the World Health Organization (<25.0, 25.0-29.9, 30.0-34.9, 35.0-39.9 and >= 40.0). Differences in postoperative improvement between the BMI groups were analysed with an overall Kruskal-Wallis test, with post hoc pairwise comparisons between BMI groups with Mann-Whitney tests.Results Of 402 patients [mean age 70.7 (SD 9.2); 55.2% women] 15.7% were normal weight (BMI <25.0), 33.1% were overweight (BMI 25.0-29.9), 28.2% had class I obesity (BMI 30.0-34.9), 16.2% had class II obesity (BMI 35.0-39.9), and 7.0% had class III obesity (BMI >= 40.0). Postoperative change in OKS (n.s.) and EQ-5D-3L (n.s.) was not associated with BMI. Higher BMI group was associated with less improvement in FJS-12 scores (p = 0.010), reflecting a greater awareness of the operated joint during activity in the most obese patients. Treatment satisfaction was associated with BMI category (p = 0.029), with obese patients reporting less satisfaction.Conclusions In TKA patients, outcome parameters are influenced differently by BMI. Our study showed a negative impact of BMI on postoperative improvement in joint awareness and satisfaction scores, but there was no influence on pain, function or general health scores. This information may be useful in terms of setting expectations expectation in obese patients planning to undergo TKA.

AB - Purpose This study investigated the impact of body mass index (BMI) on improvement in patient outcomes (pain, function, joint awareness, general health and satisfaction) following total knee arthroplasty (TKA).Methods Data were obtained for primary TKAs performed at a single centre over a 12-month period. Data were collected pre-operatively and 12-month postoperatively with the Oxford Knee Score (OKS) measuring pain and function, the EQ-5D-3L measuring general health status, the Forgotten Joint Score-12 (FJS-12) measuring joint awareness and a single question on treatment satisfaction. Change in scores following surgery was compared across the BMI categories identified by the World Health Organization (<25.0, 25.0-29.9, 30.0-34.9, 35.0-39.9 and >= 40.0). Differences in postoperative improvement between the BMI groups were analysed with an overall Kruskal-Wallis test, with post hoc pairwise comparisons between BMI groups with Mann-Whitney tests.Results Of 402 patients [mean age 70.7 (SD 9.2); 55.2% women] 15.7% were normal weight (BMI <25.0), 33.1% were overweight (BMI 25.0-29.9), 28.2% had class I obesity (BMI 30.0-34.9), 16.2% had class II obesity (BMI 35.0-39.9), and 7.0% had class III obesity (BMI >= 40.0). Postoperative change in OKS (n.s.) and EQ-5D-3L (n.s.) was not associated with BMI. Higher BMI group was associated with less improvement in FJS-12 scores (p = 0.010), reflecting a greater awareness of the operated joint during activity in the most obese patients. Treatment satisfaction was associated with BMI category (p = 0.029), with obese patients reporting less satisfaction.Conclusions In TKA patients, outcome parameters are influenced differently by BMI. Our study showed a negative impact of BMI on postoperative improvement in joint awareness and satisfaction scores, but there was no influence on pain, function or general health scores. This information may be useful in terms of setting expectations expectation in obese patients planning to undergo TKA.

KW - Total knee arthroplasty

KW - Obesity

KW - Patient-reported outcome

KW - Forgotten joint score-12

KW - Oxford Knee Score

KW - FORGOTTEN JOINT SCORE

KW - QUALITY-OF-LIFE

KW - TOTAL HIP

KW - OBESE-PATIENTS

KW - REPLACEMENT

KW - WEIGHT

KW - RELIABILITY

KW - VALIDITY

KW - OSTEOARTHRITIS

KW - VALIDATION

U2 - 10.1007/s00167-018-4853-2

DO - 10.1007/s00167-018-4853-2

M3 - Article

SN - 0942-2056

VL - 26

SP - 3257

EP - 3264

JO - Knee Surgery, Sports Traumatology, Arthroscopy

JF - Knee Surgery, Sports Traumatology, Arthroscopy

IS - 11

ER -

Patient-reported outcome metrics following total knee arthroplasty are influenced differently by patients' body mass index

Abstract

Keywords / Materials (for Non-textual outputs)

Access to Document

Fingerprint

Projects

reSTARt - Edinburgh Royal Infirmary Arthroplasty Outcomes Database

EORD: Edinburgh Orthopaedic Research Database Ethics Reference 16/SS/0026

Cite this