Bariatric Surgery Prior to Total Joint Arthroplasty, Does it Decrease the Risk of Obesity Related Perioperative Complications?
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Purpose of Review
The purpose of this review paper is to provide an overview of the relationship between obesity, osteoarthritis, arthroplasty outcomes, and the potential use of bariatric surgery to improve these outcomes.
Unfortunately, the findings in the currently available literature evaluating the role of bariatric surgery prior to arthroplasty surgery largely rely on retrospective data and their results are somewhat conflicting.
Future prospective studies are needed to further evaluate whether or not bariatric surgery prior to arthroplasty surgery may be of benefit for patients. Additional research is needed to identify other methods to minimize complications that obese patients are particularly prone to developing following arthroplasty surgery.
KeywordsObesity Bariatric surgery Arthroplasty Complications Outcomes
Compliance with Ethical Standards
Conflict of Interest
Dr. McLawhorn reports personal fees from Ethicon, personal fees from Intellijoint, outside the submitted work.
Stavrakis AI, Khoshbin A, and Parks ML declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors
Papers of particular interest, published recently, have been highlighted as: • Of importance
- 1.Obesity and overweight fact sheet. World Health Organization. Available from: http://www.who.int/mediacentre/factsheets/fs311/en/. Accessed June 2017.
- 4.Springer BD, Carter JT, McLawhorn AS, Scharf K, Roslin M, Kallies KJ, et al. Obesity and the role of bariatric surgery in the surgical management of osteoarthritis of the hip and knee: a review of the literature. Surg Obes Relat Dis. 2017 Jan;13(1):111–8. https://doi.org/10.1016/j.soard.2016.09.011.CrossRefPubMedGoogle Scholar
- 7.Changulani M, Kalairajah Y, Peel T, et al. The relationship between obesity and the age at which hip and knee replacement is undertaken. J Bone Joint Surg Br. 2008;90:3.Google Scholar
- 9.Jamsen E, Nevalainen P, Eskelinen A, Huotari K, Kalliovalkama J, Moilanen T. Obesity, diabetes, and preoperative hyperglycemia as predictors of periprosthetic joint infection: a single-center analysis of 7181 primary hip and knee replacements for osteoarthritis. J Bone Joint Surg Am. 2012;94(14):e101–-9. https://doi.org/10.2106/JBJS.J.01935.CrossRefPubMedGoogle Scholar
- 15.Boido A, Ceriani V, Cetta F, Lombardi F, Pontiroli AE. Bariatric surgery and prevention of cardiovascular events and mortality in morbid obesity: mechanisms of action and choice of surgery. Nutr Metab Cardiovasc Dis. 2015 May;25(5):437–43. https://doi.org/10.1016/j.numecd.2015.01.011.CrossRefPubMedGoogle Scholar
- 18.Belmont PJ Jr, Goodman GP, Waterman BR, Bader JO, Schoenfeld AJ. Thirty-day postoperative complications and mortality following total knee arthroplasty: incidence and risk factors among a national sample of 15,321 patients. J Bone Joint Surg Am. 2014;96(1):20–6. https://doi.org/10.2106/JBJS.M.00018.CrossRefPubMedGoogle Scholar
- 20.• Abdel MP, Bonadurer GF 3rd, Jennings MT, Hanssen AD. Increased aseptic tibial failures in patients with a BMI ≥35 and well-aligned total knee arthroplasties. J Arthroplasty. 2015;30(12):2181–4. The results in this study indicate that obese patients are at increased risk of mechanical failure of their TKA implants, specifically of the tibial component. CrossRefPubMedGoogle Scholar
- 23.Smith TO, Aboelmagd T, Hing CB, MacGregor A. Does bariatric surgery prior to total hip or knee arthroplasty reduce post-operative complications and improve clinical outcomes for obese patients? Systematic review and meta-analysis. Bone Joint J. 2016;98-B(9):1160–6. https://doi.org/10.1302/0301-620X.98B9.38024.CrossRefPubMedGoogle Scholar
- 25.Nearing EE 2nd, Santos TM, Topolski MS, Borgert AJ, Kallies KJ, Kothari SN. Benefits of bariatric surgery before elective total joint arthroplasty: is there a role for weight loss optimization? Surg Obes Relat Dis. 2017;13(3):457–62. https://doi.org/10.1016/j.soard.2016.11.005.CrossRefPubMedGoogle Scholar
- 26.• Werner BC, Kurkis GM, Gwathmey FW, Browne JA. Bariatric surgery prior to total knee arthroplasty is associated with fewer postoperative complications. J Arthroplasty. 2015;30(9 Suppl):81–5. This study analyzed the outcomes of a very large cohort of patients (>70,000), comparing outcomes based on obesity and pre-arthroplasty bariatric surgery status. CrossRefPubMedGoogle Scholar