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全髋关节置换术后体重变化:短期和长期影响。

Changes in body weight after total hip arthroplasty: short-term and long-term effects.

机构信息

Department of Orthopedic Surgery, University Medical Center Groningen, University of Groningen, PO Box 30 001 BB51, Groningen 9700 RB, the Netherlands.

出版信息

Phys Ther. 2012 May;92(5):680-7. doi: 10.2522/ptj.20110176. Epub 2012 Jan 6.

Abstract

BACKGROUND

Elevated body weight is associated with hip osteoarthritis (OA) and subsequently with total hip arthroplasty (THA). Patients with hip OA who are overweight often mention their restricted mobility as a factor that thwarts their attempts to be physically active and lose weight. There is some evidence that THA increases physical activity, but none for losing body weight after THA.

OBJECTIVE

The purpose of this study was to analyze the short-term (1-year) and long-term (4.5-year) effects of a THA on body weight.

DESIGN

This was an observational, multicenter cohort study.

METHODS

For the short-term effect, all patients (N=618) were analyzed; for the long-term effect, a random subgroup (n=100) was analyzed. Preoperative and postoperative body weight and height were self-reported. Patients were categorized according to their preoperative body mass index (BMI <25 kg/m(2)=normal weight, 25-30 kg/m(2)=overweight, >30 kg/m(2)=obese). Clinical relevancy was set at a minimum of 5% weight loss compared with baseline.

RESULTS

The mean age of the study group was 70 years (SD=8), 74% were women, and mean preoperative body mass was 79 kg (SD=14). One year after THA, a significant decrease in body weight of 1% and 3.4% occurred for the overweight and obese BMI categories, respectively. After 4.5 years, a significant decrease in body weight of 6.4% occurred for the obese BMI category.

LIMITATIONS

Height and weight-and thus BMI-were self-reported.

CONCLUSION

Patients in the overweight and obese groups showed a decrease, albeit not clinically relevant, in body weight after 1 year. After 4.5 years, a decrease that was relevant clinically was observed in the patients who were obese. It can be concluded that no clinically relevant reduction of weight occurred after THA, except in the long term for patients who were obese.

摘要

背景

超重与髋骨关节炎(OA)相关,进而与全髋关节置换术(THA)相关。超重的髋 OA 患者常提到其活动受限是阻碍他们进行身体活动和减肥的一个因素。有一些证据表明 THA 会增加身体活动量,但没有证据表明 THA 会在手术后减轻体重。

目的

本研究旨在分析 THA 对体重的短期(1 年)和长期(4.5 年)影响。

设计

这是一项观察性、多中心队列研究。

方法

为了分析短期影响,分析了所有患者(N=618);为了分析长期影响,随机抽取了一个亚组(n=100)进行分析。患者自我报告术前和术后的体重和身高。根据术前体重指数(BMI<25kg/m2=正常体重,25-30kg/m2=超重,>30kg/m2=肥胖)对患者进行分类。临床相关性设定为与基线相比至少减轻 5%的体重。

结果

研究组的平均年龄为 70 岁(SD=8),74%为女性,平均术前体重为 79kg(SD=14)。超重和肥胖 BMI 类别分别在 THA 后 1 年出现体重减轻 1%和 3.4%,4.5 年后肥胖 BMI 类别体重减轻 6.4%。

局限性

身高和体重(因此 BMI)是自我报告的。

结论

超重和肥胖组患者在 1 年后体重下降,尽管无临床意义。4.5 年后,肥胖患者的体重下降具有临床意义。可以得出结论,除了肥胖患者在长期外,THA 后体重没有明显减轻。

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