Aims The influence of metabolic syndrome (MetS) on the outcome after hip and knee arthroplasty is debated. We aimed to investigate the change in patient-reported outcome measure (PROM) scores after hip and knee arthroplasty, comparing patients with and without MetS. Methods From 1 May 2017 to 30 November 2019, a prospective cohort of 2,586 patients undergoing elective unilateral hip and knee arthroplasty was established in Denmark. Data from national registries and a local database were used to determine the presence of MetS. Patients' scores on Oxford Hip Score (OHS) or Oxford Knee Score (OKS), EuroQol five-dimension five-level questionnaire (EQ-5D-5L), University of California, Los Angeles (UCLA) Activity Scale, and Forgotten Joint Score (FJS) at baseline, three, 12, and 24 months after surgery were collected. Primary outcome was the difference between groups from baseline to 12 months in OHS and OKS. Secondary outcomes were scores of OHS and OKS at three and 24 months and EQ-5D-5L, UCLA Activity Scale, and FJS at three, 12, and 24 months after surgery. Generalized linear mixed model was applied, adjusting for age, sex, Charlson Comorbidity Index, and smoking to present marginal mean and associated 95% CIs. Results A total of 62.3% (1,611/2,586) of the cohort met the criteria for MetS. Both groups showed similar increase in mean OHS (MetS group 22.5 (95% CI 21.8 to 23.1), non-MetS group 22.1 (21.3 to 22.8); p = 0.477) and mean OKS (MetS group 18.0 (17.4 to 18.6), non-MetS group 17.8 (17.0 to 18.7); p = 0.722) at 12 months' follow-up. Between groups, similar improvements were seen for OHS and OKS at three and 24 months postoperatively and for the mean EQ-5D-5L, EuroQol-visual analogue scale (EQ-VAS), UCLA Activity Scale, and FJS at every timepoint. Conclusion Patients meeting the criteria for MetS obtain the same improvement in PROM scores as individuals without MetS up to 24 months after hip and knee arthroplasty. This is important for the clinician to take into account when assessing and advising patients with MetS.

中文翻译：

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髋关节和膝关节置换术后两年代谢综合征和患者报告的结果。


目的 代谢综合征 （MetS） 对髋关节和膝关节置换术后预后的影响存在争议。我们旨在研究髋关节和膝关节置换术后患者报告结果测量 （PROM） 评分的变化，比较有和没有 MetS 的患者。方法 2017 年 5 月 1 日至 2019 年 11 月 30 日，在丹麦建立了 2,586 例接受择期单侧髋关节和膝关节置换术患者的前瞻性队列。使用来自国家登记处和当地数据库的数据来确定 MetS 的存在。收集患者在基线、术后 3 个月、12 个月和 24 个月的牛津髋关节评分 （OHS） 或牛津膝关节评分 （OKS） 、EuroQol 五维五级问卷 （EQ-5D-5L）、加州大学洛杉矶分校 （UCLA） 活动量表和遗忘关节评分 （FJS） 评分。主要结局是 OHS 和 OKS 从基线到 12 个月的组间差异。次要结局是术后 3 个月和 24 个月时的 OHS 和 OKS 评分，以及术后 3 、 12 和 24 个月的 EQ-5D-5L 、 UCLA 活动量表和 FJS。应用广义线性混合模型，调整年龄、性别、查尔森合并症指数和吸烟，以呈现边际平均值和相关的 95% CI。结果 共有 62.3% （1,611/2,586） 的队列符合 MetS 标准。在 12 个月的随访中，两组的平均 OHS（MetS 组 22.5（95% CI 21.8 至 23.1）、非 MetS 组 22.1（21.3 至 22.8）;p = 0.477）和平均 OKS（MetS 组 18.0（17.4 至 18.6），非 MetS 组 17.8（17.0 至 18.7;p = 0.722）均显示相似增加。在各组之间，术后 3 个月和 24 个月时 OHS 和 OKS 以及平均 EQ-5D-5L 、 EuroQol 视觉模拟量表 （EQ-VAS） 、 UCLA 活动量表和 FJS 在每个时间点都观察到类似的改善。 结论 符合 MetS 标准的患者在髋关节和膝关节置换术后 24 个月内的 PROM 评分改善与未使用 MetS 的患者相同。临床医生在评估和建议 MetS 患者时必须考虑到这一点。