Track topics on Twitter Track topics that are important to you
Patients with an elevated systemic inflammatory state are known to report greater pain with knee osteoarthritis (OA). We investigated the influence of risk factors of metabolic syndrome (MetS) on patient function before and after hip and knee replacement surgery.
A total of 677 consecutive patients with primary knee replacement and 547 consecutive patients with primary hip replacement with at least one MetS risk factor were reviewed from our joint registry. Demographic variables of age, sex, and comorbidity were retrieved. MetS risk factors were defined as body mass index (BMI) > 30 kg/m(2), diabetes, hypertension, and hypercholesterolemia. Baseline and 1-year Western Ontario McMaster University Osteoarthritis Index (WOMAC) scores were compared across patients by number of MetS risk factors, ranging from 1 to 4. Linear regression modeling was used to evaluate the effects of the MetS risk groups and the individual metabolic abnormalities on predicting baseline and 1-year WOMAC scores. Knee and hip patients were reviewed separately.
The knee and hip patients showed a significant difference in sex distribution, BMI, and mean comorbidity across risk groups (p < 0.05). Unadjusted analysis showed that baseline and 1-year WOMAC scores, for both knee and hip patients, increased significantly with increasing number of MetS risk factors (p < 0.05). The linear regression model with the individual metabolic abnormalities was found to be more predictive of outcome than one with the number of MetS risk factors. Hypertension and obesity were the metabolic factors most predictive of a poorer outcome following hip surgery as compared to just obesity for knee patients.
Patient function following joint replacement surgery, particularly hip surgery, is negatively affected by metabolic abnormalities perhaps secondary to the systemic proinflammatory state. This knowledge should be used when counseling patients prior to surgery.
From the Division of Orthopedic Surgery, University of Toronto, Toronto; and the Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
This article was published in the following journal.
Name: The Journal of rheumatology
The association of obesity and other metabolic conditions with osteoarthritis is under debate; however, a strong link between metabolic disturbances is suggested to contribute to increased incidences ...
The treatment of isolated internal tibiofemoral knee osteoarthritis on young and active patients is controversial. This treatment can be a high tibial osteotomy or a joint replacement that can be a pa...
Total knee arthroplasty (TKA) is the most worldwide practiced surgery for knee osteoarthritis and its efficacy is mightily described by literature. Concerns about the invasiveness of TKA let the intro...
Total knee arthroplasty has been an effective treatment for advanced degenerative joint disease. Traditional knee designs and surgical approaches have resulted in consistently high performance, but so...
Patellar clunk syndrome is a painful mechanical phenomenon that may develop following total knee arthroplasty. The diagnosis is usually made clinically, but cross-sectional imaging may be needed to co...
A functional outcomes comparison study of three surgical techniques using minimally invasive surgery mini-incision (MIS) for total knee arthroplasty (TKA), standard para-patellar TKA and t...
Functional results with Attune Fixed Bearing Posterior Stabilized total knee arthroplasty evaluated with KOOS. A prospective longitudinal cohort study with repetitive measurements 6 weeks,...
The purpose of this study is to obtain patient oriented and clinically oriented physical function outcomes both pre-operatively and post-operatively in patients receiving a total knee arth...
Computer Aided Surgery in total knee arthroplasty improves knee stability and functional outcomes more than conventional total knee arthroplasty.
The purpose of the current study is to analyze and compare the lower-limb joint motions and muscle activation patterns during activities of daily living as well as self reported health rel...
Replacement of the knee joint.
A cluster of metabolic risk factors for CARDIOVASCULAR DISEASES and TYPE 2 DIABETES MELLITUS. The major components of metabolic syndrome X include excess ABDOMINAL FAT; atherogenic DYSLIPIDEMIA; HYPERTENSION; HYPERGLYCEMIA; INSULIN RESISTANCE; a proinflammatory state; and a prothrombotic (THROMBOSIS) state. (from AHA/NHLBI/ADA Conference Proceedings, Circulation 2004; 109:551-556)
Injuries to the knee or the knee joint.
Replacement for a knee joint.
A SYNOVIAL CYST located in the back of the knee, in the popliteal space arising from the semimembranous bursa or the knee joint.
Arthroplasty is a surgical procedure to restore the integrity and function of a joint. A joint can be restored by resurfacing the bones. An artificial joint (called a prosthesis) may also be used. Various types of arthritis may affect the joints. Osteo...
An anesthesiologist (US English) or anaesthetist (British English) is a physician trained in anesthesia and perioperative medicine. Anesthesiologists are physicians who provide medical care to patients in a wide variety of (usually acute) situations. ...
Arthritis is by definition the inflammation of one or more joints, characterized by swelling, pain, warmth, redness and diminished range of joint movement (Oxford Medical Dictionary). There are many different types; Noninflammatory; Osteoarthritis, N...