If you're severely obese and in need of total knee arthroplasty (TKA) for osteoarthritis (OA), you may be at higher risk of complications compared to those with a lower body mass index (BMI). However, a recent clinical trial suggests that undergoing bariatric surgery before TKA can significantly reduce the risk of joint surgery complications.
Bariatric surgery is a weight loss surgery that involves making changes to your digestive system to help you lose weight. It works by restricting the amount of food your stomach can hold, limiting the absorption of calories and nutrients, or both. There are several types of bariatric surgeries, including gastric bypass, sleeve gastrectomy, and adjustable gastric banding.
While bariatric surgery is an effective weight loss tool, it is not a magic solution. It requires a significant lifestyle change and ongoing support from healthcare professionals, including dietitians, exercise physiologists, and psychologists. You will need to commit to making long-term changes to your diet and exercise habits to maintain weight loss.
The study, which involved 82 adults aged 65 years and younger with class II obesity, found that those who underwent a bariatric procedure before TKA experienced fewer complications than those who underwent TKA without weight loss intervention. The primary outcome was complications of TKA measured by a composite of death from any cause, perioperative or postoperative complications resulting in a discharge delay, unplanned procedure, or readmission for at least 12 months after TKA.
The participants were randomized to undergo either bariatric surgery (41 patients) or usual weight management advice (treatment as usual [TAU]) (41 patients) before TKA. Of the 82 participants, 66 were women, the mean age was 57.8 years, and the mean BMI was 43.8.
The results of the study showed that weight loss following bariatric surgery reduced the risk of complications of TKA in people with a BMI greater than or equal to 35. Significantly fewer participants required TKA following weight loss, contributing to this finding. The between-group difference in BMI at 12 months was −6.32 in favor of the intervention group.
It is important to note that TKA was declined by 12 participants (29.3%) in the intervention group because of symptom improvement, whereas only 2 participants (4.9%) in the TAU group declined TKA. This suggests that weight loss before considering TKA can improve symptoms of knee osteoarthritis and reduce the need for joint surgery.
The findings of this study are significant for people with severe obesity and knee osteoarthritis. If you fall under this category, losing weight before considering TKA may be beneficial for reducing the risk of complications and improving symptoms.
If you have severe obesity and knee osteoarthritis, losing weight before considering TKA may be beneficial for reducing the risk of complications and improving symptoms. Bariatric surgery can be an effective weight loss tool, but it requires commitment and ongoing support from healthcare professionals. If you are considering bariatric surgery, talk to your healthcare provider to determine if it is right for you.