Metabolic syndrome was associated with a lower likelihood of achieving the minimal clinically important difference on PROMIS-PF at 1 year after THA (OR 0.58, P=0.008) and TKA (OR 0.74, P=0.029).
Cohort (n=2,181)
No
Does metabolic syndrome reduce the likelihood of achieving clinically important functional improvements at 1 year in patients undergoing primary total joint arthroplasty?
Metabolic syndrome is associated with a significantly reduced likelihood of achieving clinically meaningful functional improvement 1 year after total hip or knee arthroplasty.
Odds Ratio: 0.58
p-value: p=0.008 for THA; 0.029 for TKA
INTRODUCTION: Metabolic syndrome (MetS) is a group of conditions, including hypertension, obesity, diabetes mellitus, and dyslipidemia, that affects a notable portion of the adult US population. The purpose of this study was to evaluate the effect of MetS on 1-year functional outcomes (using the Patient-Reported Outcomes Measurement Information System-Physical Function PROMIS-PF instrument) in patients undergoing primary total hip arthroplasty (THA) or total knee arthroplasty (TKA). METHODS: A retrospective review of 2181 patients (THA n = 899, TKA n = 1282) at a single institution from 2020 to 2023 was performed. All patients completed the PROMIS-PF survey at baseline and 1 year postoperatively. Univariate and multivariate analyses were performed to compare patient characteristics and outcomes between patients with MetS and non-MetS patients. RESULTS: MetS was present in 153 (17.0%) and 317 (24.7%) of THA and TKA patients, respectively. After controlling for confounders, patients with MetS had lower rates of achieving PROMIS-PF minimal clinically important difference (MCID) at 1 year for both THA (OR, 0.58; P = 0.008) and TKA (OR, 0.74; P = 0.029). In the subgroup analysis of obese patients, MetS THA patients were less likely to achieve MCID on PROMIS-PF at 1 year (P = 0.019). CONCLUSIONS: Patients with MetS undergoing total joint arthroplasty had worse clinical outcomes and were less likely to achieve MCID on PROMIS-PF than patients without MetS. Obese THA patients with MetS were less likely to achieve MCID on PROMIS-PF. Obesity and comorbid conditions are known to increase the risk of suboptimal outcomes in patients undergoing total joint arthroplasty, and this study highlights the increased risk of patients with MetS.
Johnson et al. (Mon,) conducted a cohort in Primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) (n=2,181). Metabolic syndrome (MetS) vs. Patients without metabolic syndrome was evaluated on Achieving PROMIS-PF minimal clinically important difference (MCID) at 1 year (OR 0.58 for THA; OR 0.74 for TKA, p=0.008 for THA; 0.029 for TKA). Metabolic syndrome was associated with a lower likelihood of achieving the minimal clinically important difference on PROMIS-PF at 1 year after THA (OR 0.58, P=0.008) and TKA (OR 0.74, P=0.029).