期刊
JOURNAL OF ARTHROPLASTY
卷 32, 期 8, 页码 2404-2410出版社
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.arth.2017.03.008
关键词
osteoarthritis (OA); total knee arthroplasty (TKA); knee kinematic; gait; longitudinal study; body mass index (BMI)
类别
资金
- Division of Orthopaedics and Trauma Surgery at the University Hospitals of Geneva
- Clinical Research Center, University Hospital and Faculty of Medicine, Geneva [CH-Etude 09307 [NAC09-111]]
- Louis-Jeantet Foundation
Background: The purpose of this prospective study was to investigate the influence of body mass index (BMI) on gait parameters preoperatively and 1 year after total knee arthroplasty (TKA). Methods: Seventy-nine patients were evaluated before and 1 year after TKA using clinical gait analysis. The gait velocity, the knee range of motion (ROM) during gait, their gains (difference between baseline and 1 year after TKA), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), quality of life, and patient satisfaction were assessed. Nonobese (BMI <30 kg/m(2)) and obese patients (BMI >= 30 kg/m(2)) were compared. Healthy controls were also assessed. Univariate and multivariate linear regression analyses were used to assess the association between gait speed and ROM gains. Adjustment was performed for gender, age, and WOMAC pain improvement. Results: At baseline, gait velocity and knee ROM were significantly lower in obese compared with those in the nonobese patients (0.99 +/- 0.27 m/s vs 1.11 +/- 0.18 m/s; effect size, 0.53; P = .021; and ROM, 41.33 degrees +/- 9.6 degrees vs 46.05 degrees +/- 8.39 degrees; effect size, 0.52; P = .022). Univariate and multivariate linear regressions did not show any significant relation between gait speed gain or knee ROM gain and BMI. At baseline, obese patients were more symptomatic than nonobese (WOMAC pain: 36.1 +/- 14.0 vs 50.4 +/- 16.9; effect size, 0.9; P<.001), and their improvement was significantly higher (WOMAC pain gain, 44.5 vs 32.3; effect size, 0.59; P = .011). Conclusion: These findings show that all patients improved biomechanically and clinically, regardless of their BMI. (C) 2017 Elsevier Inc. All rights reserved.
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