Zhu David, Pailhe Regis, Mouarbes Dany, Alayane Ali, Saoudi Samy, Ben-Roummane Hasnae, Bérard Emilie, Cavaignac Etienne
Chirurgie Orthopédique Traumatologique et Arthroscopique COTA, Hôpital Central Centre Hospitalier Régional Universitaire de Nancy (CHRU) Nancy France.
Centre Chirurgical Emile Gallé, Service de chirurgie orthopédique et traumatologique Centre Hospitalier Régional Universitaire de Nancy (CHRU) Nancy France.
J Exp Orthop. 2025 Sep 9;12(3):e70426. doi: 10.1002/jeo2.70426. eCollection 2025 Jul.
The role of obesity in unicompartmental knee arthroplasty (UKA) outcomes remains debated. The aim of this study is to clarify the impact of obesity on revision rates and functional outcomes of UKA in a long-term follow-up. The hypothesis was that body mass index and weight do not significantly affect the long-term survival of UKAs.
A retrospective study was conducted on 143 UKAs performed over a 16-year period. Patients were stratified by BMI (<30 vs. ≥30 kg/m²) and weight (<82 vs. ≥82 kg). Kaplan-Meier survivorship analysis assessed the 16-year survival rates across subgroups.
The 16-year survival rates were comparable in the BMI subgroups (≥30 kg/m²: 78% (95% confidence interval [CI]: 60-88); <30 kg/m²: 84% [95% CI: 75-90]; = 0.093) but demonstrated a significant difference in the weight subgroups (<82 kg: 85% [95% CI: 76-90]; ≥82 kg: 76% [95% CI: 59-87]; = 0.045). Multivariate analysis, adjusted for confounders, showed no statistically significant impact of BMI ( = 0.202) or weight ( = 0.280) on the risk of revision. Functional outcomes, measured by knee society and self knee value scores, were unaffected by BMI at the final follow-up.
This study confirms that BMI and weight do not significantly influence the long-term survival or functional outcomes of UKA, supporting its use in obese patients when appropriately indicated.
Level IV, retrospective case series.
肥胖在单髁膝关节置换术（UKA）结局中的作用仍存在争议。本研究的目的是在长期随访中阐明肥胖对UKA翻修率和功能结局的影响。假设是体重指数和体重不会显著影响UKA的长期生存率。
对16年间进行的143例UKA进行回顾性研究。患者按体重指数（<30 vs.≥30 kg/m²）和体重（<82 vs.≥82 kg）分层。Kaplan-Meier生存分析评估各亚组的16年生存率。
体重指数亚组的16年生存率相当（≥30 kg/m²：78%（95%置信区间[CI]：60-88）；<30 kg/m²：84%[95%CI：75-90]；P = 0.093），但体重亚组存在显著差异（<82 kg：85%[95%CI：76-90]；≥82 kg：76%[95%CI：59-87]；P = 0.045）。经混杂因素校正的多变量分析显示，体重指数（P = 0.202）或体重（P = 0.280）对翻修风险无统计学显著影响。在末次随访时，通过膝关节协会和自我膝关节评分衡量的功能结局不受体重指数影响。
本研究证实体重指数和体重不会显著影响UKA的长期生存率或功能结局，支持在适当指征下用于肥胖患者。
IV级，回顾性病例系列。
