Weight loss prior to TKA fails to modify postoperative complication rate: Study

These findings revealed no significant difference in the 90-day postoperative complication rates among patients who lowered their BMI when compared to the individuals whose BMI did not change. The complication rates were similar across these groups by highlighting that a preoperative reduction in BMI did not confer expected benefits.

The study illuminated a concerning trend where nearly one-fourth of the patients underwent a significant increase in BMI during the pre-surgery period. This group showed a elevated risk of complications when compared to the individuals with stable BMI that indicates the weight gain while waiting for surgery could indeed be detrimental.

These results suggest that the strategy of delaying knee replacement surgery to achieve weight loss should be reevaluated and these findings support the need for more inclusive surgical criteria that do not necessarily cling on BMI reduction for morbidly obese patients.

Also, the patient-reported outcome measures (PROMs) that assess recovery and satisfaction levels from the patient’s perspective showed no significant differences between the groups after six weeks. This further supports the point that immediate surgical intervention without mandatory BMI reduction may be justified in this high-risk population.

Source:

LaValva, S. M., Grubel, J., Ong, J., Chiu, Y.-F., Lyman, S., Mandl, L. A., Cushner, F. D., Della Valle, A. G., & Parks, M. L. (2024). Substantial Weight Loss May Not Improve Early Outcomes of Total Knee Arthroplasty in the Morbidly Obese. In The Journal of Arthroplasty. Elsevier BV. https://doi.org/10.1016/j.arth.2024.04.015