PMID- 33419617
OWN - NLM
STAT- MEDLINE
DCOM- 20210524
LR  - 20210524
IS  - 1532-8406 (Electronic)
IS  - 0883-5403 (Linking)
VI  - 36
IP  - 5
DP  - 2021 May
TI  - Elevated Body Mass Index Is a Risk Factor for Failure to Achieve the Knee 
      Disability and Osteoarthritis Outcome Score-Physical Function Short Form Minimal 
      Clinically Important Difference Following Total Knee Arthroplasty.
PG  - 1626-1632
LID - S0883-5403(20)31258-4 [pii]
LID - 10.1016/j.arth.2020.12.019 [doi]
AB  - BACKGROUND: The aims of this study are (1) to assess the association between body 
      mass index (BMI) and failure to achieve the 1-year Knee Disability and 
      Osteoarthritis Outcome Score-Physical Function Short Form (KOOS-PS) minimal 
      clinically important difference (MCID) for total knee arthroplasty (TKA) patients 
      and (2) to determine if there is a BMI threshold beyond which the risk of failing 
      to achieve the MCID is significantly increased. METHODS: A regional arthroplasty 
      registry was queried for TKA patients from 2016 to 2019 with completion of 
      preoperative and 1-year postoperative KOOS-PS. The MCID threshold was derived 
      using a distribution-based approach. Demographic and patient-reported outcome 
      measure variables were collected. BMI was analyzed continuously and categorically 
      using cutoffs defined by the Centers for Disease Control and Prevention. The 
      association between failure to achieve 1-year MCID and BMI was analyzed using 
      multiple logistic regression. A BMI threshold was determined using the Youden 
      index and receiver operating characteristic curve. RESULTS: In total, 1059 TKAs 
      were analyzed. BMI assessed continuously was significantly associated with 
      failure to achieve the KOOS-PS MCID (odds ratio 1.03, 95% confidence interval 
      1.00-1.05, P = .025). Analysis of BMI categorically revealed that "overweight" 
      (25-30 kg/m(2)), "obese class I" (30-35 kg/m(2)), "obese class II" (35-40 
      kg/m(2)), and "obese class III" (>40 kg/m(2)) patients faced 77%, 76%, 83%, and 
      106% greater risk, respectively, of failing to achieve the KOOS-PS MCID compared 
      to "normal BMI" (<25 kg/m(2)) patients. CONCLUSION: Elevated BMI was associated 
      with an increased risk of failure to achieve the 1-year KOOS-PS MCID following 
      TKA.
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 - 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 - 20201215
PL  - United States
TA  - J Arthroplasty
JT  - The Journal of arthroplasty
JID - 8703515
SB  - IM
MH  - *Arthroplasty, Replacement, Knee/adverse effects
MH  - Body Mass Index
MH  - Humans
MH  - Minimal Clinically Important Difference
MH  - *Osteoarthritis
MH  - *Osteoarthritis, Knee/surgery
MH  - Risk Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Knee Disability and Osteoarthritis Outcome Score (KOOS)
OT  - minimal clinically important difference (MCID)
OT  - obesity
OT  - registry
OT  - total knee arthroplasty (TKA)
EDAT- 2021/01/10 06:00
MHDA- 2021/05/25 06:00
CRDT- 2021/01/09 05:29
PHST- 2020/09/28 00:00 [received]
PHST- 2020/11/22 00:00 [revised]
PHST- 2020/12/11 00:00 [accepted]
PHST- 2021/01/10 06:00 [pubmed]
PHST- 2021/05/25 06:00 [medline]
PHST- 2021/01/09 05:29 [entrez]
AID - S0883-5403(20)31258-4 [pii]
AID - 10.1016/j.arth.2020.12.019 [doi]
PST - ppublish
SO  - J Arthroplasty. 2021 May;36(5):1626-1632. doi: 10.1016/j.arth.2020.12.019. Epub 
      2020 Dec 15.