title: Effect of preoperative exercise on postoperative mobility in obese total joint replacement patients.
abstract: There has been a significant increase in obesity in the United States over the past 20 years. Reports in the literature identify the association of obesity-related osteoarthritis and the likelihood of future total hip arthroplasty (THA) and total knee arthroplasty (TKA) in this patient population. However, little is known about the effect of preoperative exercise on immediate postoperative mobility and discharge disposition in obese total joint replacement patients. The purpose of this study was to examine the effect of preoperative exercise in the obese total joint replacement patient on early postoperative mobility and discharge disposition. We retrospectively reviewed a consecutive series of patients with a body mass index (BMI) ≥30 kg/m(2) who underwent primary total joint replacement surgery from June 2005 through October 2005 at 1 institution. Two hundred seven patients met the inclusion criteria. Sixty-five patients performed self-reported preoperative exercise, defined as physical activity deemed above and beyond that of activities of daily living. Fewer exercise patients, 6.8%, required the assistance of ≥2 caregivers for mobility on postoperative day 1 vs 17.4% for nonexercisers. Fifty-four percent of patients participating in preoperative exercise were discharged home vs 46% who did not participate in exercise. A preoperative exercise program can improve postoperative functional mobility and increase the likelihood of discharge home in total joint replacement patients with a BMI of ≥30 kg/m(2).
authors.affiliation: Department of Orthopedic Surgery, New England Baptist Hospital, Tufts University School of Medicine, Boston, MA 02120, USA. crobbins@caregroup.harvard.edu
authors.forename: Claire E
authors.initials: CE
authors.lastname: Robbins
authors.forename: James V
authors.initials: JV
authors.lastname: Bono
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Ward
authors.forename: Marilyn T
authors.initials: MT
authors.lastname: Barry
authors.forename: Janice
authors.initials: J
authors.lastname: Doren
authors.forename: Amanda
authors.initials: A
authors.lastname: McNinch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000601:surgery; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D015992:Body Mass Index; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement; D009765:Obesity / Q000453:epidemiology*; D010351:Patient Discharge; D011184:Postoperative Period; D057234:Preoperative Period; D012189:Retrospective Studies