Impact of Metabolic Syndrome on Patient-Reported and Clinical Outcomes in Patients Undergoing Primary Total Joint Arthroplasty.

Abstract

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). 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. 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). 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.