Association Between Nonsurgical Weight Loss From Body Mass Index &gt;40 to Body Mass Index &lt;40 and Complications and Readmissions Following Total Hip Arthroplasty

Middleton, Austin H.; Kleven, Andrew; Creager, Ashley E.; Hanson, Ryan; Tarima, Sergey; Edelstein, Adam I.

doi:10.1016/j.arth.2021.11.024

Cited by 12 publications

(7 citation statements)

References 31 publications

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“…That is, the weight loss may not have been sufficient to change an individual’s BMI classification or improve their comorbidities. Similarly, a recent retrospective study investigating the effect of non-surgical preoperative weight loss in 1,589 patients undergoing THA found that complications were higher amongst those who lost weight [ 47 ]. It found that weight loss from a BMI >40kg/m2 to a BMI <40kg/m2 was associated with an increased risk of readmissions and complications.…”

Section: Discussionmentioning

confidence: 99%

The effect of body mass index and preoperative weight loss in people with obesity on postoperative outcomes to 6 months following total hip or knee arthroplasty: a retrospective study

Pavlovic,

Harris,

Boland

et al. 2023

Arthroplasty

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Background Few studies have investigated the association between obesity, preoperative weight loss and postoperative outcomes beyond 30- and 90-days post-arthroplasty. This study investigated whether body mass index (BMI) and preoperative weight loss in people with obesity predict postoperative complications and patient-reported outcomes 6 months following total knee or hip arthroplasty. Methods Two independent, prospectively collected datasets of people undergoing primary total knee or hip arthroplasty for osteoarthritis between January 2013 and June 2018 at two public hospitals were merged. First, the sample was grouped into BMI categories, < 35 kg/m2 and ≥ 35 kg/m2. Subgroup analysis was completed separately for hips and knees. Second, a sample of people with BMI ≥ 30 kg/m2 was stratified into participants who did or did not lose ≥ 5% of their baseline weight preoperatively. The presence of postoperative complications, Oxford Hip Score, Oxford Knee Score, EuroQol Visual Analogue Scale and patient-rated improvement 6 months post-surgery were compared using unadjusted and adjusted techniques. Results From 3,552 and 9,562 patients identified from the datasets, 1,337 were included in the analysis after merging. After adjustment for covariates, there was no difference in postoperative complication rate to 6 months post-surgery according to BMI category (OR 1.0, 95%CI 0.8–1.4, P = 0.8) or preoperative weight loss (OR 1.1, 95%CI 0.7–1.8, P = 0.7). There was no between-group difference according to BMI or preoperative weight change for any patient-reported outcomes 6 months post-surgery. Conclusion Preoperative BMI or a 5% reduction in preoperative BMI in people with obesity was not associated with postoperative outcomes to 6 months following total knee or hip arthroplasty.

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Section: Discussionmentioning

confidence: 99%

The effect of body mass index and preoperative weight loss in people with obesity on postoperative outcomes to 6 months following total hip or knee arthroplasty: a retrospective study

Pavlovic,

Harris,

Boland

et al. 2023

Arthroplasty

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“…Retrospective studies can compare complication rates in patients with an abdominal pannus who underwent medical weight loss treatments, bariatric surgery, or panniculectomy before anterior THA to rates in similar patients who did not receive treatment. A recent study found an increased complication rate in patients with obesity who lost weight before THA [5], confirming the need to validate recommendations for treating obesity as part of presurgical optimization.…”

Section: How Do We Get There?mentioning

confidence: 92%

CORR Insights®: A Radiographic Abdominal Pannus Sign is Associated With Postoperative Complications in Anterior THA

Hepinstall

2022

Clin Orthop Relat Res

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“…37 Regarding the benefits of weight loss, notable improvements in cardiovascular health, diabetes control, and HTN have been observed in patients with body mass index , 40; however, a specific weight loss goal has not been well defined in the literature. 38,39 Detailed discussion regarding the management of anemia, diabetes, and weight is covered in other articles within this series.…”

Section: Primary Care Comanagementmentioning

confidence: 99%

Movement Is Life—Optimizing Patient Access to Total Joint Arthroplasty: Cardiovascular Health Disparities

Wiznia¹,

Santos²,

Morgan³

2022

J Am Acad Orthop Surg

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Cardiovascular disease includes a collection of conditions with 6.7% of American adults having coronary artery disease and 45% having hypertension. Proper management of these conditions is low (<25%). Hypertension is highest among African Americans and is associated with lower socioeconomic status and education level. Heart disease is associated with postoperative complications, such as cardiovascular and cerebrovascular events, pulmonary and coagulopathy complications, and mortality. Underserved communities can be optimized beginning with a thorough preoperative assessment, which includes evaluating for food security, instituting dietary modifications and exercise regimens, and improving cardiovascular health with pharmacologic modalities and specialty care. Nurse navigators can be invaluable for guiding patients through a cardiovascular preoperative optimization pathway.

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Association Between Nonsurgical Weight Loss From Body Mass Index >40 to Body Mass Index <40 and Complications and Readmissions Following Total Hip Arthroplasty

Cited by 12 publications

References 31 publications

The effect of body mass index and preoperative weight loss in people with obesity on postoperative outcomes to 6 months following total hip or knee arthroplasty: a retrospective study

The effect of body mass index and preoperative weight loss in people with obesity on postoperative outcomes to 6 months following total hip or knee arthroplasty: a retrospective study

CORR Insights®: A Radiographic Abdominal Pannus Sign is Associated With Postoperative Complications in Anterior THA

Movement Is Life—Optimizing Patient Access to Total Joint Arthroplasty: Cardiovascular Health Disparities

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