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Obesity and the relative risk of replacement surgery in knee osteoarthritis patients: a prospective cohort study

Obesity and the relative risk of replacement surgery in knee osteoarthritis patients: a prospective cohort study
Obesity and the relative risk of replacement surgery in knee osteoarthritis patients: a prospective cohort study
Objective: it is unclear what the impact of obesity has on the progression of knee osteoarthritis (KOA), from diagnosis to knee replacement (KR) surgery. This research examines the relative risk of KR surgery in overweight/obese patients with newly diagnosed knee osteoarthritis in a community population.

Methods: subjects were selected from the SIDIAP database, which compiles comprehensive clinical information collected by healthcare professionals for 80% of the population of Catalonia, Spain (>5.5 million people). Patients newly diagnosed with KOA in primary care between 2006 and 2011 were included. KR was ascertained using ICD-9-CM codes from linked hospital admissions data. Multivariable Cox regression models were fitted for KR according to BMI, and were adjusted for relevant confounders. Population proportional attributable risk was calculated.

Results: 105,189 participants were followed up for a median (inter-quartile range) of 2.6 (1.3-4.2) years. 7,512 (7.1%) patients underwent KR. Adjusted HRs for KR were: 1.41 (95% CI 1.27 to 1.57) for overweight, 1.97 (1.78 to 2.18) for obese I, 2.39 (2.15 to 2.67) for obese II, and 2.67 (2.34 to 3.04) for obese III compared to normal-weight. The effect of BMI on risk of KR was stronger amongst younger participants. The population attributable risk of obesity for KOA-related KR is 31.0%.

Conclusion: overweight and obese patients are at over 40% and 100% increased risk of KR surgery compared to normal-weight respectively. This association is even stronger in younger patients. Weight reduction strategies could potentially reduce the need for KR surgery by 31% amongst KOA patients
2326-5205
817-825
Leyland, K.M.
bc5505c2-497c-4aa8-8b9b-29ee14853651
Judge, A.
c6a83964-1d7c-4aa8-b2bf-9c264d1e487d
Javaid, M.K.
51d3310b-032e-4c15-83ac-b878bce090f3
Diez-Perez, A.
19f89c53-003a-469c-92ac-69b0b979f3ec
Carr, A.
85c8478c-1212-4d8b-986f-d3c212298807
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Arden, N.K.
23af958d-835c-4d79-be54-4bbe4c68077f
Prieto-Alhambra, D.
19a5643f-5969-4c0e-b6a9-863fb9e9d1c7
Leyland, K.M.
bc5505c2-497c-4aa8-8b9b-29ee14853651
Judge, A.
c6a83964-1d7c-4aa8-b2bf-9c264d1e487d
Javaid, M.K.
51d3310b-032e-4c15-83ac-b878bce090f3
Diez-Perez, A.
19f89c53-003a-469c-92ac-69b0b979f3ec
Carr, A.
85c8478c-1212-4d8b-986f-d3c212298807
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Arden, N.K.
23af958d-835c-4d79-be54-4bbe4c68077f
Prieto-Alhambra, D.
19a5643f-5969-4c0e-b6a9-863fb9e9d1c7

Leyland, K.M., Judge, A., Javaid, M.K., Diez-Perez, A., Carr, A., Cooper, C., Arden, N.K. and Prieto-Alhambra, D. (2016) Obesity and the relative risk of replacement surgery in knee osteoarthritis patients: a prospective cohort study. Arthritis & Rheumatology, 68 (4), 817-825. (doi:10.1002/art.39486). (PMID:26556722)

Record type: Article

Abstract

Objective: it is unclear what the impact of obesity has on the progression of knee osteoarthritis (KOA), from diagnosis to knee replacement (KR) surgery. This research examines the relative risk of KR surgery in overweight/obese patients with newly diagnosed knee osteoarthritis in a community population.

Methods: subjects were selected from the SIDIAP database, which compiles comprehensive clinical information collected by healthcare professionals for 80% of the population of Catalonia, Spain (>5.5 million people). Patients newly diagnosed with KOA in primary care between 2006 and 2011 were included. KR was ascertained using ICD-9-CM codes from linked hospital admissions data. Multivariable Cox regression models were fitted for KR according to BMI, and were adjusted for relevant confounders. Population proportional attributable risk was calculated.

Results: 105,189 participants were followed up for a median (inter-quartile range) of 2.6 (1.3-4.2) years. 7,512 (7.1%) patients underwent KR. Adjusted HRs for KR were: 1.41 (95% CI 1.27 to 1.57) for overweight, 1.97 (1.78 to 2.18) for obese I, 2.39 (2.15 to 2.67) for obese II, and 2.67 (2.34 to 3.04) for obese III compared to normal-weight. The effect of BMI on risk of KR was stronger amongst younger participants. The population attributable risk of obesity for KOA-related KR is 31.0%.

Conclusion: overweight and obese patients are at over 40% and 100% increased risk of KR surgery compared to normal-weight respectively. This association is even stronger in younger patients. Weight reduction strategies could potentially reduce the need for KR surgery by 31% amongst KOA patients

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More information

Accepted/In Press date: 20 October 2015
e-pub ahead of print date: 28 March 2016
Published date: 1 April 2016
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 384100
URI: http://eprints.soton.ac.uk/id/eprint/384100
ISSN: 2326-5205
PURE UUID: cda473ad-665d-459a-bbc5-6a0e2dc7fae3
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 04 Dec 2015 14:38
Last modified: 18 Feb 2021 16:48

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Contributors

Author: K.M. Leyland
Author: A. Judge
Author: M.K. Javaid
Author: A. Diez-Perez
Author: A. Carr
Author: C. Cooper ORCID iD
Author: N.K. Arden
Author: D. Prieto-Alhambra

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