Post-Surgery Weight Loss with Anti-Obesity Meds Lowers Joint Replacement Revision Risk: Study Finds - Video

The 2023 American College of Rheumatology and American Association of Hip and Knee Surgeons Clinical Practice Guideline concluded that obesity alone should not delay joint replacement. Therefore, a substantially increased utilization of joint replacement among patients with obesity could be expected. However, patients with obesity are at increased risk of revision, posing unique challenges as the surgery is complex and costly, and it remains unknown whether postoperative weight loss could decrease the risk of revision.

With this, the researchers conducted the present study to examine the association of the proportion of postoperative weight loss following antiobesity medication use with the risk of revision among patients with obesity undergoing hip or knee replacement.

The results showed that among 3691 qualified participants, the 5-year risks of revision were 5.6%, 4.4%, and 3.7% for weight gain or stable, small-to-moderate weight loss, and large weight loss groups, respectively.

Compared with the weight gain or stable group, the hazard ratios (HRs) were 0.75 for the small-to-moderate weight loss group and 0.57 for the large weight loss group. Similar results were observed when the analyses were performed separately for hip or knee replacement. Consistent findings were obtained regarding the association of weight loss with the 10-year risks after initiating antiobesity medications.

Hence, it was concluded that in this cohort study using a target trial emulation, a higher proportion of weight loss after initiating antiobesity medications within 1 year was associated with a lower risk of 5-year and 10-year revision among patients with obesity undergoing joint replacement. These results suggest that antiobesity medication use, with relatively safe and sustainable weight loss, may be an effective strategy for improving implant survivorship of hip and knee replacements in the obese population.

Ref: Xie D, Englund M, Lane NE, Zhang Y, Li X, Wei J, Zeng C, Lei G. Postoperative Weight Loss After Antiobesity Medications and Revision Risk After Joint Replacement. JAMA Netw Open. 2025 Feb 3;8(2):e2461200. doi: 10.1001/jamanetworkopen.2024.61200. PMID: 39982723; PMCID: PMC11846009.