Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2026
Impact of Metabolic Syndrome on Patient-Reported and Clinical Outcomes in Patients Undergoing Primary Total Joint Arthroplasty.
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Johnson Andrea H, Brennan Jane C, Parker Jack, MacDonald James H, King Paul J, Turcotte Justin J
Аннотация
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.
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.