Clinically important body weight gain following total hip arthroplasty: a cohort study with 5-year follow-up

Abstract

Objective Literature examining the effects of total hip arthroplasty (THA) on subsequent body weight gain is inconclusive. Determining the extent to which clinically relevant weight gain occurs following THA has important public health implications. Design We used multivariable logistic regression to compare data from one of the largest US-based THA registries to a population-based control sample from the same geographic region. We also identified factors that increased risk of clinically important weight gain specifically among persons undergoing THA. The outcome measure of interest was weight gain of ≥ 5% of body weight up to 5 years following surgery. Results The multivariable adjusted (age, sex, BMI, education, comorbidity and pre-surgical weight change) odds ratio for important weight gain was 1.7 (95% CI, 1.06, 2.6) for a person with THA as compared the control sample. Additional arthroplasty procedures during the 5-year follow-up further increased odds for important weight gain (OR=2.0, 95% CI, 1.4, 2.7) relative to the control sample. A patient with THA had increased risk of important post-surgical weight gain of 12% (OR=1.12; 95%CI,1.08, 1.16) for every kilogram of pre-operative weight loss. Conclusions While findings should be interpreted with caution because of missing follow-up weight data, patients with THA appear to be at increased risk of clinically important weight gain following surgery as compared to peers. Patients less than 60 years and who have lost a substantial amount of weight prior to surgery appear to be at particularly high risk of important postsurgical weight gain.

Effect of Comprehensive Behavioral and Exercise Intervention on Physical Function and Activity Participation After Total Knee Replacement: A Pilot Randomized Study

“…When combing data for the 2 intervention arms, we found an overall decrease in physical activity at 6 months (162 minutes/day) compared to baseline (179 minutes/day). Although the overall decrease in physical activity was minimal (17 minutes/day), this finding converges with reports that patients after TKR tend to gain body weight . In this study, the combined sample gained 1.6 kg (83.1 kg at baseline compared to 84.7 kg at 6 months); the CBI group maintained a relatively stable body weight (increased 0.7 kg) and the SCE group experienced an increase of 2.4 kg.…”

Obesity Treatment in Orthopaedic Surgery

“…In addition, a higher preoperative functional level was significantly associated with a lower likelihood of weight gain at two-year follow-up ( P < 0.05). 34 These findings are consistent with other studies of joint arthroplasty surgery, with lower preoperative BMI and young age being associated with weight gain postoperatively. 34 In addition, it has been reported that female patients are more likely to lose weight postoperatively.…”

No clinically meaningful weight changes in a young cohort following total joint arthroplasty at 3‐year follow‐up

“…Similar to studies on TKA patients, there are inconsistent reports of weight change following THA. As seen in their similarly designed study of TKA patients, Riddle et al . again found a greater proportion of weight gains in THA patients compared to matched controls with 33.9% of THA patients experiencing clinically meaningful weight gains at 3‐year follow‐up, which increased to 37.9% at 5‐year follow‐up.…”

“…8,13,14,[23][24][25][26][27] Our findings that obese THA and TKA patients with BMIs ≥ 30 did not experience meaningful weight changes are consistent with previous studies which found no association between overweight patients and meaningful weight loss or weight gains following TKA and THA. 20,21,26 Therefore, the patient and provider should not rely on increased mobility following TJA to trigger weight loss, rather measures to attain a healthy weight following surgery should be initiated before or early in the recovery period for maximal patient benefit and implant survivorship.…”