Return to physical activity and change in body mass index after hypoallergenic medial mobile-bearing unicompartmental knee arthroplasty

Riccardo D'Ambrosi; Alessandro Nuara; Ilaria Mariani; Katia Corona; Stefan Mogos; Francesco Catellani; Michael Hantes; Nicola Ursino

doi:10.1186/s10195-021-00598-4

Return to physical activity and change in body mass index after hypoallergenic medial mobile-bearing unicompartmental knee arthroplasty

J Orthop Traumatol. 2021 Sep 18;22(1):36. doi: 10.1186/s10195-021-00598-4.

Authors

Riccardo D'Ambrosi¹, Alessandro Nuara^{2

3}, Ilaria Mariani⁴, Katia Corona⁵, Stefan Mogos⁶, Francesco Catellani⁷, Michael Hantes⁸, Nicola Ursino²

Affiliations

¹ IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. riccardo.dambrosi@hotmail.it.
² IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
³ Dipartimento Di Scienze Biomediche Per La Salute, Università Degli Studi Di Milano, Milan, Italy.
⁴ Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy.
⁵ Dipartimento Di Medicina E Scienze Della Salute Vincenzo Tiberio, Università Degli Studi del Molise, Campobasso, Italy.
⁶ Foișor Orthopaedics Hospital, Bucharest, Romania.
⁷ Humanitas Gavazzeni, Bergamo, Italy.
⁸ Department of Orthopaedic Surgery, Faculty of Medicine, University of Thessalia, University Hospital of Larissa, Larissa, Greece.

Abstract

Background: The primary purpose of the present prospective study was to consecutively analyse the outcomes of the return to sports activity of patients with positive patch tests undergoing a medial mobile-bearing titanium niobium nitride (TiNbN) unicompartmental knee arthroplasty (UKA). The secondary purpose was to ascertain if a higher grade of physical activity leads to a reduction in the body mass index (BMI) of the patients.

Material and methods: Forty-one patients with positive skin patch tests were included in this prospective study. The clinical evaluation consisted of the University of California, Los Angeles (UCLA) activity scale and the High-Activity Arthroplasty Score (HAAS). Each patient was evaluated the day before surgery (T₀), after 12.37 ± 0.70 months (T₁), and on the day of the final follow-up, after 67.03 ± 18.2 months (T₂). Furthermore, the BMI of each patient was analysed before surgery and during the final follow-up.

Results: The UCLA and HAAS mean preoperative values ranged from 3.68 ± 1.1.7 and 6.15 ± 0.76 to 6.1 ± 0.76 and 10.34 ± 1.3, respectively, at T₁ (p < 0.0001) and to the final values of 6.34 ± 0.62 and 11.0 ± 8.9, respectively, at T₂ (UCLA: T₂ versus T₁: p = 0.132; T₂ versus T₀: p < 0.0001; HAAS: T₂ versus T₁: p = 0.0027; T₂ versus T₀: p < 0.001). BMI ranged from a preoperative value of 27.97 ± 3.63 to a final value of 26.84 ± 3.11 (p < 0.0001). The only differences within the subgroups concerned patients with BMI ≥ 28, showing a superior HAAS at each follow-up (p < 0.05). A positive correlation was found between BMI and HAAS at T₀ and T₂ (p < 0.05).

Conclusions: This is the first study to evaluate the rate of the return to sports activities and change in BMI following hypoallergenic UKA. The majority of patients reduced their weight following UKA and improved their physical activity, showing outcomes that were comparable to the standard cobalt-chrome (CoCr) prostheses, regardless of gender, age, BMI and implant size.

Level of evidence: IV - Prospective Cohort Study. Trial registration researchregistry5978-Research Registry www.researchregistry.com.

Keywords: Hypoallergenic arthroplasty; Knee osteoarthritis; Return to sport; Unicompartmental knee arthroplasty.

MeSH terms

Arthroplasty, Replacement, Knee*
Body Mass Index
Exercise
Humans
Knee Joint / surgery
Knee Prosthesis*
Niobium
Osteoarthritis, Knee* / surgery
Prospective Studies
Retrospective Studies
Titanium
Treatment Outcome

Substances

titanium niobium nitride
Niobium
Titanium