Poolman Rudolf W, van Wagensveld Bart A
Onze Lieve Vrouwe Gasthuis, afd. Orthopedische chirurgie en traumatologie, Joint Research Amsterdam, the Netherlands.
Ned Tijdschr Geneeskd. 2013;157(14):A6043.
Being heavy and having knee pain often co-exists. To date, the optimal treatment for patients with osteoarthritis of the knee and obesity remains the subject of debate, since patients with a high BMI (> 30 kg/m2) have a higher risk of complications following total knee arthroplasty (TKA). Kerkhoffs and colleagues suggest that these patients should first be submitted to a weight-loss programme prior to their TKA to reduce the risk of complications. This commentary addresses various questions arising from the Dutch meta-analysis by Kerkhoffs. For instance, should patients who fail to lose weight still undergo TKA or have bariatric surgery, or are there other options? Finally, suggestions are made for future research that might shed light upon this critical issue.
体重过重与膝关节疼痛常常并存。迄今为止，对于膝关节骨关节炎和肥胖患者的最佳治疗方法仍是一个有争议的话题，因为体重指数（BMI）较高（> 30 kg/m²）的患者在全膝关节置换术（TKA）后出现并发症的风险更高。Kerkhoffs及其同事建议，这些患者在进行全膝关节置换术前应首先接受减肥计划，以降低并发症风险。本评论探讨了Kerkhoffs的荷兰荟萃分析中出现的各种问题。例如，减肥失败的患者是仍应接受全膝关节置换术还是进行减肥手术，或者还有其他选择？最后，针对未来可能阐明这一关键问题的研究提出了建议。
