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

Inacio, Maria C.S.; Silverstein, Donna Kritz; Raman, Rema; Macera, Caroline A.; Nichols, Jeanne F.; Shaffer, Richard A.; Fithian, Donald C.

doi:10.7812/tpp/13-082

Cited by 36 publications

(19 citation statements)

References 31 publications

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“…Weight changes among knee replacement patients appear to be highly variable among individuals, which is similar to other populations [38]. In a recent study, Inacio and colleagues [37] suggest that men were less likely to lose weight after surgery and older patients are less likely to gain weight; however more research is needed to identify additional and consistent characteristics that are linked with both pre- and post-operative weight loss. If specific characteristics are identified, behavioral interventions could be adapted or individually tailored accordingly to meet the specific needs of the patients, ultimately enhancing weight loss.…”

Section: Discussionmentioning

confidence: 77%

“…[37] It is likely that these differences are due to varying definitions of weight maintenance used (+/− 2.5% vs. +/− 5%) and only those with radiographic knee osteoarthritis were included in the current analyses. Weight changes among knee replacement patients appear to be highly variable among individuals, which is similar to other populations [38].…”

Section: Discussionmentioning

confidence: 99%

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Patients Less Likely to Lose Weight Following a Knee Replacement

et al. 2017

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BACKGROUND Knee replacement typically results in reduced pain and improved function, but it is unclear if these improvements lead to weight loss. OBJECTIVE The purpose of this study was to examine weight change patterns pre- and post-operatively among overweight/obese knee replacement patients. METHODS The study evaluated 210 overweight/obese patients from the Osteoarthritis Initiative who underwent a knee replacement during an 8 year longitudinal study. Average annual weight changes during 1–2 year intervals prior to, including, and subsequent to knee replacement were categorized as loss (≥−2.5%), maintain (>−2.5% to <2.5%), and gain (≥2.5%). Weight changes across time intervals were compared using logistic regression with generalized estimating equations, adjusting for demographic, health, and knee factors. RESULTS On average, patients lost (−0.6 kg/yr) during the interval when the surgery was performed, but weight gain (0.9 kg/yr) in the initial post-operative interval represented an overall net weight gain (0.3 kg/yr) compared to pre- surgery. Continued weight gain (0.3 kg/yr) was also seen among patients with additional follow-ups. Patients were significantly less likely to have a meaningful weight loss in the time interval immediately following the surgery compared to the interval in which the surgery took place (odds ratio=0.37, 95% confidence interval: 0.18, 0.79). CONCLUSION Overweight and obese patients initially lost weight during the interval including knee replacement, however they were less likely to lose >2.5% of their weight in the 1–2 years immediately after the surgery. Knee replacement patients may benefit from weight management interventions both pre- and post-operatively.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Patients Less Likely to Lose Weight Following a Knee Replacement

et al. 2017

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“…A similar trend of maintenance of BMI levels above the ideal was observed in men and women. Other studies have observed a greater tendency of women to lose weight post-surgery and a lower propensity for men to either lose or gain weight in both the pre- and postoperative periods, in addition to a lower propensity for weight gain in older patients 24, 25. Stets et al 26 also found that only 21.5% of their patients presented a reduction in BMI; in the other patients, weight was maintained (59.2%) or increased (19.9%).…”

Section: Discussionmentioning

confidence: 86%

Do patients lose weight after total knee replacement?

Schwartsmann

Borges

Freitas

et al. 2017

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveSeveral studies show that patients undergoing total knee arthroplasty (TKA) tend to maintain or gain weight after the procedure, which would result in increased wear of the prosthesis and new surgical interventions in a smaller period of time in comparison with patients with adequate body mass index (BMI). The aim of this study was to investigate the effect of TKA surgery on these patients’ BMI.MethodsInitially the records were analyzed, chosen at random from 91 patients undergoing TKA during the period from August 2011 to July 2013. Patients were stratified by BMI as normal weight (BMI between 20 and 25), overweight (BMI between 25 and 30), and obesity (BMI > 30). They were re-evaluated in a minimum period of 18 months.ResultsThe mean age of the sample population was 68.1 years; 69.1 for men and 67.2 for women. The mean preoperative BMI was 27.24 kg/m2. Among the study participants, in the preoperative period, 17 patients had normal weight, 65 were overweight, and nine were obese. Postoperative analysis showed weight loss in 41 patients (46%), and weight gain in 50 patients (54%). The mean postoperative BMI was 27.16 kg/m2, in general, experiencing a slight decline in the mean BMI of 0.08 kg/m2.ConclusionPatients who underwent TKA did not achieve significant reduction in BMI after surgery.

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“…Of the remaining studies, 21 met the inclusion criteria. Following detailed assessment of the full manuscripts, five studies (2 reviews, 2 with no control groups and 1 with no relevant reported outcomes) were excluded. The remaining 16 publications included four RCTs and 12 cohort studies, of which four 33–35,37 were prospective and eight retrospective.…”

Section: Resultsmentioning

confidence: 99%

Meta-analysis of the influence of lifestyle changes for preoperative weight loss on surgical outcomes

Roman

Monaghan

Serraino

et al. 2019

Journal of British Surgery

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Background The aim was to investigate whether preoperative weight loss results in improved clinical outcomes in surgical patients with clinically significant obesity. Methods This was a systematic review and aggregate data meta‐analysis of RCTs and cohort studies. PubMed, MEDLINE, Embase and CINAHL Plus databases were searched from inception to February 2018. Eligibility criteria were: studies assessing the effect of weight loss interventions (low‐energy diets with or without an exercise component) on clinical outcomes in patients undergoing any surgical procedure. Data on 30‐day or all‐cause in‐hospital mortality were extracted and synthesized in meta‐analyses. Postoperative thromboembolic complications, duration of surgery, infection and duration of hospital stay were also assessed. Results A total of 6060 patients in four RCTs and 12 cohort studies, all from European and North American centres, were identified. Most were in the field of bariatric surgery and all had some methodological limitations. The pooled effect estimate suggested that preoperative weight loss programmes were effective, leading to significant weight reduction compared with controls: mean difference –7·42 (95 per cent c.i. –10·09 to –4·74) kg (P < 0·001). Preoperative weight loss interventions were not associated with a reduction in perioperative mortality (odds ratio 1·41, 95 per cent c.i. 0·24 to 8·40; I2 = 0 per cent, P = 0·66) but the event rate was low. The weight loss groups had shorter hospital stay (by 27 per cent). No differences were found for morbidity. Conclusion This limited preoperative weight loss has advantages but may not alter the postoperative morbidity or mortality risk.

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

Cited by 36 publications

References 31 publications

Patients Less Likely to Lose Weight Following a Knee Replacement

Patients Less Likely to Lose Weight Following a Knee Replacement

Do patients lose weight after total knee replacement?

Meta-analysis of the influence of lifestyle changes for preoperative weight loss on surgical outcomes

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