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- Title
Obesity should not be considered a contraindication to medial Oxford UKA: long-term patient-reported outcomes and implant survival in 1000 knees.
- Authors
Molloy, James; Kennedy, James; Jenkins, Cathy; Mellon, Stephen; Dodd, Christopher; Murray, David
- Abstract
<bold>Purpose: </bold>Some health providers ration knee arthroplasty on the basis of body mass index (BMI). There is no long-term data on the outcome of medial mobile-bearing unicompartmental knee arthroplasty (UKA) in different BMI groups. This study aimed to determine the effect of patient body mass index (BMI) on patient-reported outcomes and long-term survival of medial UKA in a large non-registry cohort. Our hypothesis is that increasing BMI would be associated with worse outcomes.<bold>Methods: </bold>Data were analysed from a prospective cohort of 1000 consecutive medial mobile-bearing Oxford UKA with mean 10-year follow-up. Patients were grouped: BMI < 25, BMI 25 to < 30, BMI 30 to < 35 and BMI 35+. Oxford Knee Score (OKS) and Tegner Activity Score were assessed at 1, 5 and 10 years. Kaplan-Meier survivorship was calculated and compared between BMI groups.<bold>Results: </bold>All groups had significant improvement in OKS and Tegner scores. BMI 35 + kg/m2 experienced the greatest overall increase in mean OKS of 17.3 points (p = 0.02). There was no significant difference in ten-year survival, which was, from lowest BMI group to highest 92%, 95%, 94% and 93%.<bold>Conclusion: </bold>There was no difference in implant survival between groups, and although there was no consistent trend in postoperative OKS, the BMI 35+ group benefited the most from UKA. Therefore, when UKA is used for appropriate indications, high BMI should not be considered to be a contraindication. Furthermore rationing based on BMI seems unjustified, particularly when the commonest threshold (BMI 35) is used.<bold>Level Of Evidence: </bold>III.
- Subjects
KNEE surgery; BODY mass index; ARTHROPLASTY; MEDICAL function tests; BODY weight; OBESITY; OBESITY complications; ARTIFICIAL joints; KNEE; KNEE diseases; LONGITUDINAL method; OSTEOARTHRITIS; POSTOPERATIVE period; TOTAL knee replacement; TREATMENT effectiveness; DISEASE complications
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2019, Vol 27, Issue 7, p2259
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-018-5218-6