The obesity challenge in joint replacement: a multifaceted analysis of self-reported health status and exercise capacity using NHANES data: a population-based study

• Published in: International journal of surgery (London, England) Vol. 110; no. 6; pp. 3212 - 3222
• Main Authors: Zhang, Xianzuo, Shen, Xianyue, Bai, Jiaxiang, Zang, Wanli, Chen, Mo, Maimaitiabula, Abasi, Zhu, Chen
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 01.06.2024
• Subjects: Adult; Aged; Arthroplasty, Replacement; Body Mass Index; Exercise Tolerance - physiology; Female; Health Status; Humans; Male; Middle Aged; Nutrition Surveys; Obesity - complications; Obesity - epidemiology; Obesity - physiopathology; Original Research; Self Report
• ISSN: 1743-9159; 1743-9191; 1743-9159
• DOI: 10.1097/JS9.0000000000001287

Joint replacement is successful for end-stage oeteoarthritis, with obesity linked to elevated risk. But the impact of obesity on self-reported health and exercise capacity among joint replacement patients remains complex and requires investigation. This study utilizes data from the National Health and Nutrition Examination Survey (NHANES) to examine the relationship between obesity severity, demographic factors, medical comorbidities, and self-reported health status. The relationship between general health status and BMI was analyzed using multivariable regression, and further illustrated using a restricted cubic spline. Additionally, a bibliometric analysis and systematic review was done to frame the research within the broader context of existing knowledge and demographic specifics. Analysis of NHANES data involving 327 joint replacement patients yielded intriguing insights. The difference in self-reported health between BMI groups did not achieve conventional statistical significance ( P =0.06), and multivariable analysis showed that even severely obese patients did not exhibit significantly elevated risk of poor/fair self-reported health compared to normal weight subjects. Among severely obese individuals (BMI>40), 40.63% still rated their health positively. However, stratified analyses indicated that obesity correlated with negative health reports across sex, age, and education strata. Notably, physical functioning emerged as a robust predictor of self-reported health, with those reporting no walking difficulties having significantly lower odds of poor/fair health (Odds ratio=0.37, P =0.01). The study highlights the need for healthcare providers to consider individual physical abilities and comorbidities alongside obesity severity when discussing treatment options with joint replacement patients. It supports tailored interventions and informed shared decision-making. Future research could explore effective weight management strategies for obese individuals undergoing joint replacement.