Bariatric Surgery Improves Total Joint Replacement Recovery in Obese Patients

Bariatric surgery could be beneficial for morbidly obese patients prior to total knee or hip replacement surgery, researchers say. A recent study by Hospital for Special Surgery (HSS) found that weight loss surgery can reduce in-hospital recovery times and decrease postoperative complications associated with total joint replacement. However, it does not reduce the risk of needing revision surgery in the future.

Previous studies have linked obesity to postoperative infection, delayed recovery, decreased functionality, and the need for revision surgery after total knee or hip replacement. Obesity is also a significant risk factor for osteoarthritis, which contributes to joint pain and loss of cartilage.

HHS researchers used the New York Statewide Planning and Research Cooperative System (SPARCS) database to analyze all morbidly obese patients who underwent total knee or hip replacement surgery in New York State between 1997 and 2011. Researchers then compared the cost and treatment outcomes of patients who underwent total knee replacement with no prior weight loss to patients who underwent total knee replacement two years after bariatric surgery.

Using a statistical technique called propensity score matching, researchers determined that patients who underwent bariatric surgery were 75 percent less likely to suffer in-hospital complications after hip replacement surgery and 31 percent less likely to have complications from knee replacement surgery. The risk for developing 90-day postoperative complications was also much lower in this group, with a 14 percent decreased risk after hip replacement and a 61 percent decrease after knee replacement. Weight loss surgery did not, however, reduce the risk of hip dislocation or revision surgery.

“With our data, I think we can say with confidence that bariatric surgery prior to total joint replacement is not a harmful recommendation," said orthopedic surgeon and lead study author Alexander McLawhorn, MD, MBA. "As an orthopedic surgeon, you are not going to compromise your joint replacement outcome if you advise a morbidly obese patient to seek an opinion from a bariatric surgeon."

The findings of this study were presented at the American Academy of Orthopedic Surgeons Annual Meeting in March (Source: News-Medical.Net).