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Are Knee and Foot Orthopedic Problems More Disabling in the Superobese?

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Abstract

Background

Aiming to ascertain whether frequency and severity of knee and foot problems were different between morbid obesity (MO) and superobesity (SO), a prospective clinical study was designed.

Methods

Bariatric candidates (N = 81, body mass index 40–81.3 kg/m2, 43.2 % with SO) were submitted to knee and foot radiologic assessment, baropodometric footprint measurement, and the questionnaires Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Foot and Ankle Outcome Score (FAOS). Main outcome measures were imaging diagnosis of knee osteoarthritis and flatfoot, along with functional impact on activities of daily living estimated by the questionnaires.

Results

Knee osteoarthritis was radiologically diagnosed in 74.1 % (60/81), and the entire cohort suffered from flatfoot according to both footprint index and talar-first metatarsal radiographic angle; nevertheless, distribution was not different between SO and MO. However, WOMAC and FAOS scores were markedly worse in SO, affecting joint pain, stiffness, and general mobility. This is the first protocol of our knowledge to address foot and knee derangements in SO.

Conclusions

Functional impairment was more severe in SO, despite a morphologic pattern similar to MO. Even though amelioration is probable with weight loss, long-term orthopedic assistance might be required in such circumstances.

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Acknowledgments

The valuable help of an Ajinomoto PhD Grant and of CNPq Grant 302915/2011-7 is appreciated.

Conflict of Interest

The authors have no commercial associations that might be a conflict of interest in relation to this article.

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Authors and Affiliations

  1. S.J. Rio Preto Medical School, São José do Rio Preto, Sao Paulo, Brazil

    Sonia M. Fabris, Sergio L. A. Brienze & Gilberto B. Brito

  2. Hospital das Clinicas, Sao Paulo, Brazil

    Sonia M. Fabris, Joel Faintuch & Ivan Cecconello

  3. Private Practice, São José do Rio Preto, Sao Paulo, Brazil

    Isabela S. Sitta & Estevao L. P. Mendes

  4. Department of Statistics, Londrina State University, Londrina, Parana, Brazil

    Ines C. B. Fonseca

  5. Hospital das Clinicas, ICHC, 9th Floor, Room 9077, Av. Eneias C. Aguiar 255, Sao Paulo, Sao Paulo, 05403-900, Brazil

    Joel Faintuch

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  1. Sonia M. Fabris
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  2. Joel Faintuch
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  3. Sergio L. A. Brienze
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  4. Gilberto B. Brito
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  7. Ines C. B. Fonseca
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  8. Ivan Cecconello
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Correspondence to Joel Faintuch.

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Fabris, S.M., Faintuch, J., Brienze, S.L.A. et al. Are Knee and Foot Orthopedic Problems More Disabling in the Superobese?. OBES SURG 23, 201–204 (2013). https://doi.org/10.1007/s11695-012-0778-x

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  • DOI: https://doi.org/10.1007/s11695-012-0778-x

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