Bariatric Surgery Prior to Total Knee Arthroplasty is Associated With Fewer Postoperative Complications

Does bariatric surgery prior to total hip or knee arthroplasty reduce post-operative complications and improve clinical outcomes for obese patients?

“…23,24 On meta-analysis, there was no statistically significant difference in requirement for post-operative blood transfusion between the two bariatric management cohorts …”

“…A summary of the characteristics of the included studies is presented in 21,23 Two studies presented the data as classified by whether participants had received bariatric surgery within or longer than two years before their arthroplasty procedure. 22,24 The other three studies did not document the duration between bariatric surgery and arthroplasty for their cohorts.…”

“…Three studies recruited both cases and controls at the same time. [21][22][23] Finally no studies performed a power calculation to determine whether they analysed sufficient numbers of participants to detect a statistically significant difference.…”

How viable is pre-surgery weight reduction for the reduction of periprosthetic joint infection risk after total joint arthroplasty?

“…A 2015 review of the PearlDriver database identified 219 patients who underwent bariatric surgery before TKA. Compared to morbidly obese patients who had not had prior bariatric surgery, these patients had a significantly lower risk of developing a postoperative infection with an odds ratio of 0.36 [14]. In a smaller matched cohort study of patients undergoing total hip arthroplasty, there was a trend toward a decreased risk of PJI (4% vs. 10%), but the difference was not statistically significant.…”

CORR Insights®: Do Stemmed Tibial Components in Total Knee Arthroplasty Improve Outcomes in Patients With Obesity?

“…Bariatric surgery has been employed extensively during the last decade to facilitate weight loss [3]. Werner and colleagues [15] evaluated three large patient cohorts categorized as nonobese, morbidly obese who had not received bariatric surgery, and morbidly obese who underwent bariatric surgery prior to TKA. The authors found a reduced rate of both major and minor complications in the bariatric cohort when compared to the morbidly obese cohort who did not undergo bariatric surgery.…”