Recently, a study published by JAMA Network Open showed that patients with higher physical constitution index (BMI) before total knee arthroplasty (TKA) had poor physical function after TKA, while patients with lower osteoarthritis had better surgical outcomes. In addition, researchers also revealed that more than 20% of patients cannot restore physical function after TKA.
Research Design
No improvement in physical function is a risk factor related to more expensive revision surgery and can bring huge burdens on the individual, medical insurance system and socioeconomic levels.
To explore the effects of preoperative factors on physical function after TKA, Olsen et al. conducted a systematic review of the studies published from January 1, 2000 to October 8, 2021 and a meta-analysis of .
studies were searched in Medline, Embase, Cumulative Index of Nursing and Related Health Literatures (CINAHL), Cochrane Library , and Physical Therapy Evidence Database (PEDro), without language limitations. The study selected prospective observational studies or randomized clinical trials to explore the effects of preoperative factors on physical function 3, 6 and 12 months after surgery. The main outcome of the
study was physical function at 12 months postoperatively, and the secondary outcome was physical function at 3 months and 6 months postoperatively.
study results
This meta-analysis screened 12,052 articles, and finally included 20 studies, 11,317 patients and 37 different factors. In terms of the relationship between postoperative function, the average correlation coefficient of estimated by high BMI was -0.15 (95% CI: –0.24 to –0.05, P=0.33, moderate certainty evidence); the average correlation coefficient with better physical function was 0.14 (95% CI: 0.02-0.26, P=0.03, low certainty evidence). The mean correlation coefficient for severe osteoarthritis (OA) was 0.1 (95% CI: 0.01-0.19, P=0.17, highly definitive evidence).
researchers said these studies showed that higher BMI was associated with poor physical function (moderate certainty evidence); better physical function (low certainty evidence) and more severe OA (high certainty evidence) were associated with better physical function 12 months after TKA. These factors should be included in the prediction model development to identify patients with an increased risk of physical dysfunction after TKA.
Yimaitong compiled from: Erich Martin. Patients with higher BMI have worse physical function after total knee artroplasty. Healio. September 14, 2022.
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