Total weight loss associated with increased physical activity after bariatric surgery may increase the need for total joint arthroplasty

Surg Obes Relat Dis. 2014 Mar-Apr;10(2):335-9. doi: 10.1016/j.soard.2013.09.011. Epub 2013 Sep 21.

Abstract

Background: Retrospectively, our institution noticed an increased number of patients undergoing total joint arthroplasty (TJA) after bariatric surgery. Considering that bariatric surgery is a proven modality to reduce osteoarthritic pain, we sought to identify a reason some patients may later require TJA. The objective of this study was to investigate the hypothesis that rapid or increased weight loss after bariatric surgery may be a risk factor for TJA.

Methods: Weight loss parameters were retrospectively assessed in 15 bariatric surgery patients who subsequently received a primary TJA and compared with matched bariatric controls.

Results: Patients who required a TJA lost 27.9% more of their body mass index (BMI) compared with controls (P = .049). Furthermore, patients who underwent TJA 25-48 months postbariatric surgery lost 78.2% more of their BMI compared with controls (P<.001). Total knee arthroplasty patients lost 43.9% more of their BMI compared with controls (P = .02), and the difference in BMI change for total hip arthroplasty patients was not significant versus controls.

Conclusion: These results contradict the tenant that weight loss is universally protective against arthritis and merit larger prospective investigations.

Keywords: Bariatric surgery; Rapid weight loss; Total hip arthroplasty; Total knee arthroplasty.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Arthroplasty, Replacement / adverse effects*
  • Bariatric Surgery*
  • Body Mass Index
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Massachusetts / epidemiology
  • Middle Aged
  • Motor Activity / physiology*
  • Obesity / complications*
  • Obesity / epidemiology
  • Osteoarthritis / etiology*
  • Osteoarthritis / surgery
  • Postoperative Period
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Weight Loss*