PMID- 33303327
OWN - NLM
STAT- MEDLINE
DCOM- 20210630
LR  - 20210630
IS  - 1532-8406 (Electronic)
IS  - 0883-5403 (Linking)
VI  - 36
IP  - 7S
DP  - 2021 Jul
TI  - Obesity Increases Risk of Failure to Achieve the 1-Year PROMIS PF-10a Minimal 
      Clinically Important Difference Following Total Joint Arthroplasty.
PG  - S184-S191
LID - S0883-5403(20)31164-5 [pii]
LID - 10.1016/j.arth.2020.11.004 [doi]
AB  - INTRODUCTION: The aims of this study were to determine if increasing body mass 
      index (BMI) is a risk factor for failure to attain the 1-year Patient Reported 
      Outcomes Measurement Information System Physical Function (PROMIS PF-10a) minimal 
      clinically important difference (MCID) following total joint arthroplasty (TJA) 
      and to determine a possible BMI threshold beyond which this risk increases 
      significantly. METHODS: This retrospective study was performed using 3506 TJAs 
      sourced from a regional-based registry. An anchor-based MCID threshold of 7.9 was 
      chosen. PROMIS PF-10a scores were collected at the preoperative and 1-year 
      postoperative timepoints, and the change was used to determine failure to achieve 
      the 1-year MCID. Demographic and surgical variables were also collected. The 
      association between BMI and failure to achieve 1-year PROMIS PF-10 MCID was then 
      evaluated using logistic regression. A BMI threshold was determined using 
      receiver operating characteristic (ROC) curve analysis. RESULTS: Increasing BMI 
      assessed continuously was a significant risk factor for failure to achieve the 
      MCID (P < .001). "Obese Class I" (30-35 kg/m(2)), "Obese Class II" (35-40 
      kg/m(2)), and "Obese Class III" (>40 kg/m(2)) subgroups compared to "Normal BMI" 
      (<25 kg/m(2)) were significantly associated (P < .05) with this adverse outcome 
      as well. CONCLUSION: Our study showed that increasing BMI is a risk factor for 
      failure to achieve the 1-year PROMIS PF-10a MCID following TJA. Among our 
      patients, an increase in 1 kg/m(2) increased the risk of failure to achieve the 
      MCID by 2%. With these findings, surgeons will be better equipped to 
      preoperatively advise patients with elevated BMIs considering TJA.
CI  - Copyright (c) 2020 Elsevier Inc. All rights reserved.
FAU - Katakam, Akhil
AU  - Katakam A
AD  - Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard 
      Medical School, Boston, MA; Department of Orthopaedic Surgery, Newton-Wellesley 
      Hospital, Newton, MA.
FAU - Collins, Austin K
AU  - Collins AK
AD  - Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard 
      Medical School, Boston, MA.
FAU - Sauder, Nicholas
AU  - Sauder N
AD  - Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard 
      Medical School, Boston, MA.
FAU - Shin, David
AU  - Shin D
AD  - Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard 
      Medical School, Boston, MA.
FAU - Bragdon, Charles R
AU  - Bragdon CR
AD  - Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard 
      Medical School, Boston, MA.
FAU - Chen, Antonia F
AU  - Chen AF
AD  - Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical 
      School, Boston, MA.
FAU - Melnic, Christopher M
AU  - Melnic CM
AD  - Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard 
      Medical School, Boston, MA; Department of Orthopaedic Surgery, Newton-Wellesley 
      Hospital, Newton, MA.
FAU - Bedair, Hany S
AU  - Bedair HS
AD  - Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard 
      Medical School, Boston, MA; Department of Orthopaedic Surgery, Newton-Wellesley 
      Hospital, Newton, MA.
LA  - eng
PT  - Journal Article
DEP - 20201110
PL  - United States
TA  - J Arthroplasty
JT  - The Journal of arthroplasty
JID - 8703515
SB  - IM
MH  - Arthroplasty
MH  - Humans
MH  - *Minimal Clinically Important Difference
MH  - Obesity/complications/epidemiology
MH  - *Patient Reported Outcome Measures
MH  - Retrospective Studies
OTO - NOTNLM
OT  - MCID
OT  - PROMIS
OT  - THA
OT  - TKA
OT  - obesity
EDAT- 2020/12/12 06:00
MHDA- 2021/07/01 06:00
CRDT- 2020/12/11 05:44
PHST- 2020/08/20 00:00 [received]
PHST- 2020/10/25 00:00 [revised]
PHST- 2020/11/02 00:00 [accepted]
PHST- 2020/12/12 06:00 [pubmed]
PHST- 2021/07/01 06:00 [medline]
PHST- 2020/12/11 05:44 [entrez]
AID - S0883-5403(20)31164-5 [pii]
AID - 10.1016/j.arth.2020.11.004 [doi]
PST - ppublish
SO  - J Arthroplasty. 2021 Jul;36(7S):S184-S191. doi: 10.1016/j.arth.2020.11.004. Epub 
      2020 Nov 10.