Do Patients Lose Weight After Joint Arthroplasty Surgery? A Systematic Review

Abstract

Background The ability of patients with a total joint arthroplasty (TJA) to lose weight after surgery has been investigated in a few studies with inconsistent results. Questions/Purposes We asked: (1) What is the quality of evidence of current published literature on postoperative weight trends for patients who have had a TJA? (2) Do patients lose any weight after TJA? (3) Do patients lose a clinically meaningful amount of weight after TJA?Methods We conducted a systematic review of PubMed and the Cochrane Library. Studies were summarized according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement. Studies were reviewed for quality of evidence and limitations according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. Twelve studies were identified, one case-cohort study and 11 case series. Most studies were from single-surgeon or single-hospital series. Five studies included THAs and TKAs, four only THAs, and three only TKAs. We determined study type, level of evidence, inclusion criteria, procedures, proportion of patients who changed weight, body composition assessment, time of composition assessment, statistical analysis performed, and subgroup analysis conducted. Results Owing to the observational nature of the studies and the serious limitations identified, all were considered very low quality according to GRADE criteria. Studies reported 14% to 49% of patients had some weight loss at least 1 year postoperatively. Conclusions We found no conclusive evidence that weight or body composition increases, decreases, or remains the same after TJA.

Patients Less Likely to Lose Weight Following a Knee Replacement

“…For example, some evidence suggested that patients experience no change in weight while others observed weight gains after the knee replacement [20–24]. A recent systematic review also suggested that there was not conclusive evidence on weight changes following joint replacement [25]; however previous studies have not been limited to overweight and obese patients. Thus, using data from the Osteoarthritis Initiative (OAI) [26], a multisite longitudinal study, we examined the weight change patterns approximately one to four years pre- and post-operatively among overweight and obese patients with radiographic knee osteoarthritis who underwent a knee replacement.…”

Weight Patterns Before and After Total Joint Arthroplasty and Characteristics Associated with Weight Change

“…Conversely, several studies have focused on weight changes of patients after TJA, but with inconclusive findings. 12 These inconclusive results, which are also inconsistent, may have been because of the heterogeneity of study eligibility and analyses performed, small sample sizes, or overall quality. 12 Thus, no conclusive evidence exists that weight improves, remains the same, or negatively progresses any time after TJA procedures.…”

Weight Changes After Total Hip or Knee Arthroplasty

“…A recent meta-analysis by Inacio et al 9 showed that small studies exist demonstrating both weight loss and weight gain after total hip arthroplasty or total knee arthroplasty, but most are underpowered. Furthermore, studies that demonstrated weight change after arthroplasty did not evaluate whether any predictors of such change exist.…”