Weight loss before Total Knee Arthroplasty improves outcomes: JAMA

The key findings of this study were as follow:

1. Eighty-two patients awaiting TKA were randomly assigned to either TAU or bariatric surgery.

2. The average (SD) age of the 82 participants was 57.8 (4.9) years, and the average (SD) BMI was 43.8. (5.5).

3. Thirty-nine (95.1%) patients in the intervention group received laparoscopic adjustable gastric banding, and 29 (70.7%) later underwent TKA.

4. TKA was performed on 39 patients (95.1%) in the TAU group.

5. The main result was experienced by six patients (14.6%) in the intervention group vs 15 (36.6%) in the TAU group.

6. At 12 months, the difference in BMI between groups was 6.32 in favor of the intervention group.

7. TKA was dropped by 12 people (29.3%) in the intervention group due to symptom improvement, whereas TKA was declined by 2 participants (4.9%) in the TAU group.

In conclusion, the results of this randomized controlled trial show that losing weight before TKA reduced the incidence of problems following TKA in individuals with a BMI greater than 35 with OA. It also appears to cause a significant number of patients to postpone TKA surgery.

Reference:

Dowsey, M. M., Brown, W. A., Cochrane, A., Burton, P. R., Liew, D., & Choong, P. F. (2022). Effect of Bariatric Surgery on Risk of Complications After Total Knee Arthroplasty. In JAMA Network Open (Vol. 5, Issue 4, p. e226722). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2022.6722