体重指数大于40对于接受肩关节置换术的患者而言并不预示着更差的预后。
Body mass index greater than 40 does not portend worse outcomes for patients undergoing shoulder arthroplasty.
作者信息
Rhead James A, Dinapoli Noah, Fares Ani, Dy Frank, Beck Edward C, Trasolini Nicholas A, Graves Benjamin, Waterman Brian R, Reynolds Alan W
机构信息
Department of Orthopaedic Surgery & Rehabilitation, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
出版信息
Shoulder Elbow. 2025 Aug 12:17585732251368811. doi: 10.1177/17585732251368811.
BACKGROUND
Conflicting data exists surrounding the impact of body mass index (BMI) on total shoulder arthroplasty (TSA) outcomes.
METHODS
This retrospective study reviewed patients undergoing primary anatomic and reverse TSA with ≥2-year follow-up and completed patient-reported outcome measures (PROMs), including American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numeric Evaluation (SANE) score, and Visual Analog Scale. PROMs and range of motion (ROM) were analyzed based on BMI and other metabolic factors, including hemoglobin A1C, albumin, low-density lipoprotein, total cholesterol, and vitamin D.
RESULTS
A total of 217 patients were included, with an average follow-up of 34 months. No differences were found in ROM or PROMs at final follow-up, based on categorical BMIs of <30, 30-40, and >40 kg/m. However, BMI > 40 was associated with greater improvements in ASES ( = 0.018) and SANE ( = 0.028) scores. Achievement of ASES minimal clinically important difference was also higher in patients with a higher BMI as a continuous variable ( = 0.019), likely due to lower pre-operative scores. Other metabolic factors were not independently associated with final PROMs.
CONCLUSION
Obesity, including BMI > 40 kg/m, does not negatively impact perceived and functional improvement following TSA.
背景
关于体重指数（BMI）对全肩关节置换术（TSA）疗效的影响，存在相互矛盾的数据。
方法
这项回顾性研究对接受初次解剖型和反式TSA且随访时间≥2年的患者进行了评估，并完成了患者报告的结局指标（PROMs），包括美国肩肘外科医师学会（ASES）评分、单项评估数字评定法（SANE）评分和视觉模拟量表。基于BMI和其他代谢因素，包括糖化血红蛋白、白蛋白、低密度脂蛋白、总胆固醇和维生素D，对PROMs和活动范围（ROM）进行了分析。
结果
共纳入217例患者，平均随访34个月。根据BMI分类<30、30-40和>40 kg/m，末次随访时ROM或PROMs未发现差异。然而，BMI>40与ASES（P=0.018）和SANE（P=0.028）评分的更大改善相关。作为连续变量，BMI较高的患者达到ASES最小临床重要差异的比例也更高（P=0.019），这可能是由于术前评分较低。其他代谢因素与最终的PROMs无独立相关性。
结论
肥胖，包括BMI>40 kg/m，不会对TSA术后的感知和功能改善产生负面影响。
Zotero 插件