Morbidly Obese Patients May Benefit From Bariatric Surgery Prior To Knee Replacement Surgery

A new research study  appearing in the Journal of Bone and Joint Surgery, supports bariatric surgery in morbidly obese patients with end-stage osteoarthritis (loss of cartilage and joint pain, caused by aging and use) prior to Total Knee Replacement Surgery TKR.

A large number of patients who need Knee Replacement Surgery are  obese (a body mass index (BMI) > 30 kg/m2) and obesity is a known risk factor for osteoarthritis. While TKR is a typical treatment for end-stage osteoarthritis, obesity places patients at an increased risk for complications, including delayed wound healing, infection, the need for revision surgery, and lower functional outcomes.

During the evaluation, researchers used a computer model to analyze previously published data on obesity, bariatric surgery and TKR. The evaluation compared the costs and outcomes of two treatment options for patients with morbid obesity (a BMI ?35 kg/m2) and end-stage knee osteoarthritis: The first, TKR without prior weight loss; and the second, TKR two years after bariatric surgery.

“We know that bariatric surgery can be an effective treatment for morbid obesity, reducing a patient’s excess weight. In addition, the surgery also reduces the burden of co-morbidities, like diabetes and high blood pressure, and may extend a patient’s life span,” said orthopaedic surgeon and lead article author   It is certainly more cost effective and prudent to recommend bariatric surgery to achieve weight loss and improve preoperative health prior to joint replacement.”

The model predicts that patients with morbid obesity who undergo bariatric surgery two years prior to TKR are more likely to enjoy improved quality-of-life, measured in quality-adjusted life years (QALYs), than patients undergoing TKR without prior weight loss surgery.

“We found that successful bariatric surgery performed two years before TKR could be a cost-effective treatment strategy for morbidly obese patients with end-stage arthritis. A large number of patients who are at early stage arthritis and Obese can surely benefit from bariatric surgery to reduce weight and even avoid Knee Replacement later on

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