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IF 3.4 2区医学 Q1 ORTHOPEDICS

Journal of Arthroplasty Pub Date : 2025-03-04 DOI:10.1016/j.arth.2025.02.070

Kevin B Fricka, Tobenna N Nwankwo, Robert A Sershon, Nancy L Parks, Alexander V Strait, William G Hamilton

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引用次数: 0

摘要

导言：之前的一些研究表明，肥胖会增加单髁膝关节置换术（UKA）失败的风险。本研究评估了肥胖对单侧膝关节置换术结果的影响：我们分析了 2000 年至 2022 年间由八位外科医生实施的 4973 例初次内侧骨水泥单髁膝关节置换术。主要结果是植入物存活率。次要结果包括翻修率、翻修原因、患者报告结果和临床指标。平均年龄为66岁（范围在33岁至96岁之间），54.6%为女性，体重指数（BMI）平均为29.9（范围在15.6岁至63.4岁之间），平均随访时间为5.1年。结果按体重指数分界线（体重指数：30；35；40）进行分层，得出的组别规模为：≤30（N = 2,858）、>30（N = 2,115）、≤35（N = 4,137）、>35（N = 836）、≤40（N = 4,680）和>40（N = 293）：五年和十年后，植入体的存活率分别为 95.7% 和 92.8%。五年后的存活率仍然很高，但随着体重指数（BMI）的增加，30和35分界线的存活率略有下降（≤30：96.7%，>30：94.2%，P < 0.001；≤35：95.8%，>35：94.9%；P = 0.005），而体重指数>40的存活率略有上升，但无显著性差异（≤40：95.7%，>40：96.0%；P = 0.325）。关节炎进展是最常见的翻修原因，随着体重指数的增加而增加。所有体重指数的感染率都很低。使用膝关节骨关节炎结果评分、关节置换（KOOS，JR）达到最小临床重要性差异的患者比例在每个体重指数临界值之间没有差异，但使用体重指数 30 临界值时，体重指数较高的患者的 KOOS、JR 评分变化明显更大（P = 0.034）：虽然体重指数较高的患者的翻修率略有增加，但由于所有体重指数组群的感染率都较低，PROMs 也有所改善，因此我们仍然对这些患者的 UKA 充满热情。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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The Influence of Obesity on Unicondylar Knee Arthroplasty.

Background: Some prior studies suggest obesity increases unicondylar knee arthroplasty (UKA) failure risk. This study evaluated obesity's impact on UKA outcomes at a single institution.

Methods: We analyzed 4,973 primary cemented medial UKAs performed by eight surgeons from 2000 to 2022. The primary outcome was implant survivorship. Secondary outcomes included revision rates, reasons for revision, patient-reported outcomes, and clinical metrics. The mean age was 66 years (range, 33 to 96), 54.6% were women, body mass index (BMI) averaged 29.9 (range, 15.6 to 63.4), and follow-up averaged 5.1 years. Outcomes were stratified by BMI cutoffs (BMI: 30; 35; 40), yielding group sizes of ≤ 30 (N = 2,858), > 30 (N = 2,115), ≤ 35 (N = 4,137), > 35 (N = 836), ≤ 40 (N = 4,680), and > 40 (N = 293).

Results: At 5 and 10 years, implant survivorship was 95.7 and 92.8%, respectively. At 5 years, survivorship remained high but declined slightly with increased BMI for the 30 and 35 cutoffs (≤ 30: 96.7%, > 30: 94.2%, P < 0.001; ≤ 35: 95.8%, > 35: 94.9%; P = 0.005), while a slight, nonsignificant increase occurred for BMI > 40 (≤ 40: 95.7%, > 40: 96.0%; P = 0.325). Arthritis progression was the most common revision reason, and it increased with BMI. Infection rates remained low across all BMIs. There was no difference in the percentage of patients achieving a minimal clinically important difference using the Knee Osteoarthritis Outcome Score, Joint Replacement with each BMI cutoff, but Knee Osteoarthritis Outcome Score, Joint Replacement score changes were significantly greater in the higher BMI patients using the BMI 30 cutoff (P = 0.034).

Conclusions: While higher BMI patients had marginally higher rates of revision, we remain enthusiastic about UKA in these patients due to low infection rates across all BMI cohorts and improvements in patient-reported outcome measures.

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来源期刊

Journal of Arthroplasty 医学-整形外科

CiteScore

7.00

自引率

20.00%

发文量

734

审稿时长

48 days

期刊介绍： The Journal of Arthroplasty brings together the clinical and scientific foundations for joint replacement. This peer-reviewed journal publishes original research and manuscripts of the highest quality from all areas relating to joint replacement or the treatment of its complications, including those dealing with clinical series and experience, prosthetic design, biomechanics, biomaterials, metallurgy, biologic response to arthroplasty materials in vivo and in vitro.