Rheumatology Department, Biomedical Research Institute August Pi i Sunyer (IDIBAPS), Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain,
Obes Surg. 2011 Aug;21(8):1203-8. doi: 10.1007/s11695-010-0197-9.
The impact of obesity on total knee replacement (TKR) outcomes is unclear. Studies use different classifications of obesity and heterogeneous methods, making comparisons difficult. The aim of this study was to evaluate health-related quality of life (HRQL) preoperatively and at 12 months of follow-up in severe and morbidly obese patients with knee osteoarthritis and a control group of nonobese patients undergoing TKR.
Case-control study with 12 months follow-up. HRQL was measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. Sociodemographic variables, comorbidity, body mass index (BMI), degree of intra-operative difficulty (IOD), in-patient data, and postoperative medical data were collected. The effect size (ES) was measured for the different outcome measures. Comparison of the two groups after 12 months of follow-up was made using the t test.
sixty patients (88% women) with a mean age of 70.2 years (SD 6.7) and mean total WOMAC dimension score 61.4 (SD 16.7).
60 matched controls. There were 88% women, with a mean age of 71.7 years (SD 6.7), and a mean WOMAC score of 58.2 (SD 13.4). There were significant improvements in all WOMAC dimensions compared to baseline (p < 0.001) in both groups. There were no differences in WOMAC dimension scores between the two groups at 12 months. The study group had more IOD (p = 0.014) and more-severe complications in the follow up.
Severe and morbidly obese and nonobese patients had similar change scores and TKR outcomes in terms of HRQL at 12 months after TKR. Obese patients had more intraoperative difficulties and more-severe postoperative complications.
肥胖对全膝关节置换术（TKR）结果的影响尚不清楚。研究使用不同的肥胖分类和异质方法，使得比较变得困难。本研究的目的是评估严重和病态肥胖的膝骨关节炎患者与非肥胖 TKR 对照组患者术前和 12 个月随访时的健康相关生活质量（HRQL）。
这是一项具有 12 个月随访的病例对照研究。使用 Western Ontario and McMaster Universities Osteoarthritis Index（WOMAC）问卷评估 HRQL。收集社会人口统计学变量、合并症、体重指数（BMI）、术中难度程度（IOD）、住院数据和术后医疗数据。测量了不同结局测量的效应大小（ES）。使用 t 检验比较两组患者在 12 个月随访后的差异。
60 名患者（88%为女性），平均年龄 70.2 岁（SD 6.7），平均总 WOMAC 维度评分 61.4（SD 16.7）。
60 名匹配的对照者。88%为女性，平均年龄 71.7 岁（SD 6.7），WOMAC 评分平均为 58.2（SD 13.4）。两组患者在所有 WOMAC 维度上与基线相比均有显著改善（p<0.001）。两组患者在 12 个月时的 WOMAC 维度评分无差异。研究组的 IOD（p=0.014）和随访中更严重的并发症更多。
在 TKR 后 12 个月，严重和病态肥胖与非肥胖患者在 HRQL 方面的 TKR 结果的变化评分相似。肥胖患者的手术难度更大，术后并发症更严重。
