A Literature Review and Summary Recommendations of the Impact of Bariatric Surgery on Orthopedic Outcomes.

Obesity Surgery
Michel M MurrRoger Ndindjock

Abstract

Many surgeons recommend weight loss in preparation for orthopedic procedures, yet the impact of surgically induced weight loss before orthopedic procedures is not clear. We undertook a literature review to assess the impact of bariatric surgery on the outcomes of total joint arthroplasty (TJA). We searched PubMed, Medline, Cochrane Library, and Google Scholar for studies (2010-2017) that evaluated the associations between obesity, bariatric surgery, and orthopedic surgery. Nine studies found that prior bariatric surgery decreased major and minor post-operative complications, operating room (OR) time, length of stay (LOS), risk of re-operation, and 90-day re-admissions after TJA. Two studies found that bariatric surgery patients had a higher reoperation rate for stiffness and infection as well as need for revision within 90 days after TJA. One meta-analysis found no statistically significant differences in wound infections, revisions, or mortality irrespective of bariatric surgery status; and another meta-analysis showed reduced medical complications, LOS, and OR time. Our review highlights many gaps in our knowledge and the need for additional studies to define the impact of the bariatric-first approach on TJA outcomes. We prop...Continue Reading

References

Jan 5, 2011·The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland·A KulkarniM R Reed
Jun 21, 2011·Lancet·Johannes W J BijlsmaFloris P J G Lafeber
May 5, 2012·The Journal of Arthroplasty·Erik P SeversonDavid G Lewallen
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Mar 23, 2013·The Journal of Arthroplasty·UNKNOWN Workgroup of the American Association of Hip and Knee Surgeons Evidence Based Committee
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Jul 11, 2013·Clinical Orthopaedics and Related Research·Qais NaziriMichael A Mont
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Aug 2, 2014·The Journal of Arthroplasty·Diren ArsoyRobert T Trousdale
Jun 14, 2015·The Journal of Arthroplasty·Brian C WernerJames A Browne
Jan 23, 2016·The Journal of Bone and Joint Surgery. American Volume·Alexander S McLawhornEmily R Dodwell
Feb 5, 2016·The Journal of Bone and Joint Surgery. American Volume·Kimona IssaMichael A Mont
Nov 21, 2016·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Bryan D SpringerShanu N Kothari
Dec 25, 2016·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Emanuel E NearingShanu N Kothari

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