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Obese patients show limited improvement in overall physical function 2 years after TSA
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Although investigators found improved shoulder function in obese patients after total shoulder arthroplasty at short-term follow-up, they discovered no significant improvement in overall physical function for these patients after the procedure.
“Our study found that with short-term follow-up, obesity does not have a detrimental effect on functional outcomes and complication rates in patients after [total shoulder arthroplasty] TSA,” a researcher of the study Xinning Li, MD, from Boston University School of Medicine, stated in an American Academy of Orthopaedic Surgeons press release. “In the normal body mass index (BMI) patient group, both the shoulder function and the overall physical function improved after TSA. However, among patients diagnosed with obesity, we found that the shoulder function improved after TSA, but the overall physical function did not improve at final follow-up.”
The findings were published in the Journal of Bone & Joint Surgery.
According to the study abstract, Li and colleagues categorized 76 patients who underwent TSA according to BMI into normal weight, overweight and obese groups. The investigators measured SF-36, American Shoulder and Elbow Surgeons (ASES), visual analog scale (VAS) pain and fatigue scores preoperatively and at 2-year follow-up and noted any complications in the groups.
The mean ASES scores improved and the mean VAS pain scores decreased in all groups from preoperative measures to 2-year follow-up. However, while the SF-36 scores significantly increased from 38.3 ± 6.5 points preoperatively to 53.7 ± 11.3 points at 2-year follow-up in the normal weight group, the improvement for this measure for the same time point was not significant for the overweight (36.1 ± 8 points to 39.8 ± 12.2 points) and obese groups (36.3 ± 8.4 points to 40.7 ± 12.4 points). There was one deep infection in the overweight group and two revisions in the normal weight group.
“This data suggests that in the normal BMI patient group who are active, that their overall physical function may have been limited due to shoulder pain,” Li stated in the release. “Therefore, a total shoulder replacement was able to provide this patient population (normal BMI) with improved shoulder function which resulted in a better physical function.”
References:
Li X. J Bone Joint Surg Am. 2013;doi:10.2106/JBJS.L.011.45.
www.aaos.org
Disclosure: The authors have no relevant financial disclosures.