Akhil Katakam1, Isabella S Florissi2, Yhan E Colon Iban2, Charles R Bragdon2, Antonia F Chen3, Christopher M Melnic1, Hany S Bedair1. 1. Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Orthopaedic Surgery, Newton-Wellesley Hospital, Newton, MA. 2. Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA. 3. Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Abstract
BACKGROUND: The relationship between obesity and failure to achieve a minimal clinically important difference (MCID) following total hip arthroplasty (THA) has not been well defined. The aims of this study are to determine whether increasing body mass index (BMI) is associated with failure to achieve the 1-year Hip Disability and Osteoarthritis Outcome Score-Physical Function Short Form (HOOS-PS) MCID and to determine a threshold BMI beyond which this risk is significantly increased. METHODS: A multi-institutional arthroplasty registry was queried for THA patients from 2016 to 2018 with completion of preoperative and 1-year postoperative HOOS-PS. A previously defined anchor-based MCID threshold of 23 was used. Variables collected included demographics and patient-reported outcome measures. BMI was analyzed continuously and categorically. The association was analyzed via logistic regression. A BMI threshold was determined using the Youden index and receiver operating characteristic curve. RESULTS: A total of 1256 THAs were included. The average HOOS-PS improvement was 27.6 ± 18 points. The area under the receiver operating characteristic curve for BMI and risk of failure to achieve HOOS-PS MCID was 0.54 (95% confidence interval [CI], 0.50-0.57). Increasing BMI assessed continuously was a significant risk factor (odds ratio [OR], 1.03; 95% CI, 1.01-1.05; P value = .010). When BMI was analyzed categorically, this association was only observed for obese class III patients (>40 kg/m2) (OR, 2.5; 95% CI, 1.21-5.3; P value = .010). CONCLUSION: This study found an association between increasing BMI and failure to achieve the 1-year HOOS-PS MCID. Obese class III patients (>40 kg/m2) face a near 3-fold increased risk of suffering this adverse outcome.
BACKGROUND: The relationship between obesity and failure to achieve a minimal clinically important difference (MCID) following total hip arthroplasty (THA) has not been well defined. The aims of this study are to determine whether increasing body mass index (BMI) is associated with failure to achieve the 1-year Hip Disability and Osteoarthritis Outcome Score-Physical Function Short Form (HOOS-PS) MCID and to determine a threshold BMI beyond which this risk is significantly increased. METHODS: A multi-institutional arthroplasty registry was queried for THA patients from 2016 to 2018 with completion of preoperative and 1-year postoperative HOOS-PS. A previously defined anchor-based MCID threshold of 23 was used. Variables collected included demographics and patient-reported outcome measures. BMI was analyzed continuously and categorically. The association was analyzed via logistic regression. A BMI threshold was determined using the Youden index and receiver operating characteristic curve. RESULTS: A total of 1256 THAs were included. The average HOOS-PS improvement was 27.6 ± 18 points. The area under the receiver operating characteristic curve for BMI and risk of failure to achieve HOOS-PS MCID was 0.54 (95% confidence interval [CI], 0.50-0.57). Increasing BMI assessed continuously was a significant risk factor (odds ratio [OR], 1.03; 95% CI, 1.01-1.05; P value = .010). When BMI was analyzed categorically, this association was only observed for obese class III patients (>40 kg/m2) (OR, 2.5; 95% CI, 1.21-5.3; P value = .010). CONCLUSION: This study found an association between increasing BMI and failure to achieve the 1-year HOOS-PS MCID. Obese class III patients (>40 kg/m2) face a near 3-fold increased risk of suffering this adverse outcome.
Authors: Bryant M Song; Yining Lu; Ryan R Wilbur; Ophelie Lavoie-Gagne; Ayoosh Pareek; Brian Forsythe; Aaron J Krych Journal: Arthrosc Sports Med Rehabil Date: 2021-11-12
Authors: Nishanth Muthusamy; Thomas Christensen; Vivek Singh; Chelsea Sue Sicat; Joshua C Rozell; Ran Schwarzkopf; Claudette M Lajam Journal: Arthroplasty Date: 2022-09-08