Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
J Arthroplasty. 2021 Jun;36(6):1974-1979. doi: 10.1016/j.arth.2021.01.059. Epub 2021 Jan 28.
Previous studies evaluating weight changes following total knee arthroplasty (TKA) were performed on heterogenous cohorts. However, no study has evaluated weight changes in a cohort of simultaneous-bilateral TKA (SB-TKA) patients. This study aimed to evaluate the prevalence of patients who lost or gained weight, determine if postoperative weight change influences functional outcome, and identify predictors of weight change after SB-TKA.
Prospectively collected registry data of 560 patients who underwent SB-TKA were reviewed. Patients were assessed preoperatively, at 6 months, and 2 years using the Knee Society Score, Oxford Knee Score, Short-Form 36, and range of motion. Change in body mass index (BMI) >5% was used to categorize patients into 3 groups: lost, maintained, or gained weight. Analysis of variance, Kruskal-Wallis test, and chi-squared test were used to compare functional outcomes between groups. Multivariable logistic regression evaluated predictors for postoperative weight changes.
At 2 years, 59% of patients maintained weight, 28% of patients gained weight, and 13% of patients lost weight. All groups experienced similar improvements in functional outcomes, rates of minimal clinically important difference attainment, and patient satisfaction (P > .05). Older patients were more likely to gain weight (P < .05). Patients with higher preoperative BMI were more likely to gain weight (P < .05) and less likely to lose weight (P < .05). Patients with greater preoperative comorbidities were less likely to lose weight (P < .05).
Up to 41% of patients experience significant weight changes after SB-TKA. Older patients with higher preoperative BMI were more likely to gain weight, while higher preoperative BMI with more comorbidities were less likely to lose weight following SB-TKA; however, postoperative weight changes do not appear to affect functional outcomes.
III, therapeutic study.
既往评估全膝关节置换术（TKA）后体重变化的研究纳入了异质性队列。然而，尚无研究评估同期双侧 TKA（SB-TKA）患者的体重变化。本研究旨在评估体重减轻或增加的患者比例，确定术后体重变化是否影响功能结局，并确定 SB-TKA 后体重变化的预测因素。
对 560 例接受 SB-TKA 的患者前瞻性收集的登记数据进行了回顾。患者在术前、术后 6 个月和 2 年分别使用膝关节学会评分（Knee Society Score）、牛津膝关节评分（Oxford Knee Score）、健康调查简表 36 项（Short-Form 36）和关节活动度进行评估。体重指数（BMI）变化＞5%用于将患者分为 3 组：体重减轻、维持或增加。采用方差分析、Kruskal-Wallis 检验和卡方检验比较各组间的功能结局。多变量逻辑回归评估术后体重变化的预测因素。
术后 2 年，59%的患者维持体重，28%的患者体重增加，13%的患者体重减轻。所有组的功能结局、获得最小临床重要差异的比例和患者满意度均有类似改善（P＞.05）。年龄较大的患者更可能体重增加（P＜.05）。术前 BMI 较高的患者更可能体重增加（P＜.05），体重减轻的可能性较小（P＜.05）。术前合并症较多的患者更不可能减轻体重（P＜.05）。
高达 41%的患者在 SB-TKA 后出现明显的体重变化。年龄较大、术前 BMI 较高的患者更有可能体重增加，而术前 BMI 较高、合并症较多的患者更不可能减轻体重；然而，术后体重变化似乎不会影响功能结局。
III，治疗性研究。
