Takeaway
This meta-analysis suggests that obesity does not result in poorer post-operative outcomes following unicompartmental knee arthroplasty (UKA) for osteoarthritis and should not be considered a contradiction for UKA.
Why this matters
The use of UKA for single compartment end-stage OA has significantly increased and studies have suggested that this procedure has good functional outcomes and offers several advantages over total knee arthroplasty. However, its use in patients with obesity has been surrounded by controversy.
Findings warrant further studies to examine factors associated with obesity and consider stratifying obesity to better delineate any potential differences in outcomes.
Study design
30 studies (mean follow-up duration, 5.42 years) including 80,798 patients met eligibility criteria after a search on MEDLINE, EMBASE, Cochrane, PubMed and Web of Science.
Funding: None disclosed.
Key results
Subgroup meta-analyses revealed no statistically significant difference following UKA between patients with and without obesity in overall:
complication rates (OR, 1.36; 95% CI, 0.54-3.43; P=.52; I2, 97%);
infection rates (OR, 1.09; 95% CI, 0.54-2.17; P=.81; I2, 80%); and
revision surgeries (OR, 1.60; 95% CI, 0.98-2.62; P=.06; I2, 86%).
When further analysing complications, no significant differences were seen in:
minor complications (OR, 1.82; 95% CI, 0.69-4.89; P=.23; I2, 91%);
major complications (OR, 1.36; 95% CI, 0.32-5.68; P=.68; I2, 97%); and
venous thromboembolism rates (OR, 0.77; 95% CI, 0.58-1.01; P=.06; I2, 72%).
No significant differences were seen for revision surgeries specifically for:
infection (OR, 0.89; 95% CI, 0.49-1.63; P=.71); and
aseptic loosening (OR, 1.05; 95% CI, 0.79-1.39; P=.75).
Limitations
Heterogeneity among included studies.
This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.
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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Sarfaroj Khan. Obesity Does Not Influence the Outcome of Unicompartmental Knee Arthroplasty for Osteoarthritis - Medscape - Dec 01, 2020.
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