Can knee arthroplasty play a role in weight management in knee osteoarthritis?
Can knee arthroplasty play a role in weight management in knee osteoarthritis?
复制标题
膝关节置换术能否在膝骨关节炎的体重管理中发挥作用？
DOI：
10.1002/acr.21881
复制
发表时间：
2013
影响因子：
4.7
通讯作者：
Rosal,MilagrosC
中科院分区：
文献类型：
--
作者：
Franklin,PatriciaD;Rosal,MilagrosC
Primary total knee arthroplasty (TKA) is effective in relieving pain and improving patient-reported physical function in patients with advanced knee osteoarthritis. Consequently, the demand for TKA, particularly among younger active adults, is growing significantly (1). Although improved postoperative function is well documented, little is known about whether the gain in functional ability translates into new physical activity habits that will support weight management. Moreover, the majority of preoperative TKA patients have a body mass index (BMI) in the obese range and report low levels of physical activity due to the combination of knee pain, obesity, and associated comorbidities (2, 3). Therefore, in this issue of Arthritis Care & Research, Riddle and colleagues (4) pose an important public health question: do TKA patients have improved ability to manage weight after successful surgery?Riddle et al report weight change over a 5-year period following TKA among 917 patients from the Mayo Clinic knee registry database compared to weight change of an age-and sex-matched population-based random sample of 237 persons from the Rochester Epidemiology Project. Thirty percent of patients with a successful TKA gained 5% or more of baseline body weight at 5 years after surgery compared to 20% of the control group. Adjusted for age, sex, BMI, education, comorbidity, and presurgical weight change, multivariate analysis showed that patients undergoing TKA were at greater risk (odds ratio 1.6, 95% confidence interval 1.2–2.2) of a gain of 5% or more of body weight over a period of 5 years following surgery compared to the control group over the same time period. In addition, patients ages 70 years, those who had greater weight loss prior to surgery, or those undergoing additional arthroplasty surgeries were at higher risk of weight gain. Not surprisingly, younger patients who lost a large
