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Weight gain seen in most patients after TKA
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Most patients gain weight during the 2 years following total knee arthroplasty, according to the results of a recent study conducted by investigators from the University of Delaware.
The findings were published in the January 15, 2010 online edition of Osteoarthritis and Cartilage.
“For physical therapists and surgeons, the common thinking is that after a patient’s knee has been replaced, that patient will be more active,” Lynn Snyder-Mackler, PT, ATC, SCS, ScD, an author of the study and professor of physical therapy at the University of Delaware, stated in the release. “But the practices and habits these patients developed to get around in the years prior to surgery are hard to break, and often they don’t take advantage of the functional gain once they get a new knee.
Snyder-Mackler, and colleague Joseph A. Zeni Jr., PhD, discovered that patients typically lose weight in the first few weeks following total knee arthroplasty (TKA). Most patients then began to gain weight, according to a university press release.
For their study, the investigators compared 106 patients with end-stage osteoarthritis who underwent TKA to an age-matched, healthy control group of 31 individuals who did not have surgery. The investigators measured the height, weight, quadriceps strength and self-perceived functional ability of the participants at baseline and at 2-year follow-up, according to the release.
“We saw a significant increase in body mass index over 2 years for the surgical group, but not the control group,” Zeni, a research assistant professor at the university, stated in the release. “Sixty-six percent of the people in the surgical group gained weight over the 2 years—the average weight gain was 14 pounds.”
Patients in the surgical group were heavier at baseline and were heavier at the end of the study period than those in the control group. The investigators noted that patients in the surgical group with weaker quadriceps gained more weight.
Snyder-Mackler noted that patients should not wait too long to undergo TKA because preoperative functional levels typically predict postoperative function.
Weight gain following a unilateral TKA can be troublesome because it could affect the patient’s other knee, according to the release. Between 35% and 40% of patients will have surgery on their contralateral knees within 10 years.
The authors of the study recommended that weight gain after TKA be treated as a separate concern and that a combination of approaches be integrated into postoperative care, including nutritional counseling and an increased emphasis on retraining patients to walk normally.
- Reference:
Zeni JA Jr, Snyder-Mackler L. Most patients gain weight in the 2 years after total knee arthroplasty: Comparison to a healthy control group. Osteoarthritis and Cartilage. In press. Published online 15 January 2010.
