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• W2093605856 abstract "Purpose: Varus alignment and obesity are both risk factors for the progression of medial compartment knee OA and are the targets of various interventions. The purpose of the present study was to evaluate the effect of preoperative weight loss on knee-related outcome measures after medial opening wedge high tibial osteotomy (HTO) for patients with obesity, varus alignment and medial compartment knee OA. We hypothesized that decreases in body weight preoperatively would result in better knee-related outcomes 6 months postoperatively. Methods: A total of 16 patients participated in this prospective cohort study with matched historical controls. Eight patients completed an 8-week physiotherapy program (2days/week), supplemented with fat loss and body composition seminars (1day/week). These patients were matched to historical controls based on sex, age (within 5 years), BMI (within 2 points), Kellgren and Lawrence grade in the medial compartment, and Knee Injury and Osteoarthritis Outcome Score (KOOS) Pain Domain (within 10 points). Outcome measures included the following: 3D gait analysis (external knee adduction moment and gait speed), all KOOS domains, the Lower Extremity Functional Scale (LEFS) and the Short Form 12 (SF-12) health status questionnaire. Changes from baseline to 6 months after surgery were compared between groups using paired t-tests. Results: The mean weight-loss before surgery was 4.7 kg (95%CI: 2.7, 6.8 kg) for the weight-loss group. Their mean weight-gain 6 months after surgery was 1.5 kg (95%CI: -0.6, 3.6 kg). At 6 months after surgery, weight in the preoperative weight-loss group was significantly lower than the controls [mean difference (95%CI): -2.5 kg (-5.4, -0.3 kg)]. Both groups improved substantially on all outcomes after surgery. However, there were no significant differences between groups. Between-group mean differences (95%CI) in change scores were as follows (weight-loss group minus control group): Peak knee adduction moment, -1.9 Nm (-16.1, 13.8 Nm); gait speed, 0.07 m/sec (-0.09, 0.22 m/sec); KOOS Pain domain, -2.1 (-21.3, 17.2); LEFS, -3.6 (-19.7, 12.4); SF-12 physical component summary, 1.5 (-7.8, 10.7); SF-12 mental component summary, 1.8 (-7.6, 11.3). Conclusions: Although the extremes of the 95% confidence intervals do not exclude potentially clinically important differences between groups, the present results suggest that obese patients with medial compartment knee OA who lose weight before medial opening wedge HTO do not have significantly better knee-related outcomes 6 months postoperatively than similar patients who do not lose weight preoperatively." @default.
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• W2093605856 date "2012-04-01" @default.
• W2093605856 modified "2023-09-26" @default.
• W2093605856 title "Effect of preoperative weight loss on postoperative outcomes after high tibial osteotomy in patients with obesity, varus alignment and medial compartment knee OA" @default.
• W2093605856 doi "https://doi.org/10.1016/j.joca.2012.02.504" @default.
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