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Successful ankle fusion or total ankle replacement does not equal weight loss

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KEYSTONE, Colo. – Patients who underwent successful ankle fusion or total ankle replacement did not achieve a reduction in body mass index over time, according to a presenter at the 2011 Annual Meeting of the American Orthopaedic Foot and Ankle Society, here.

“Overweight and obese patients do not typically lose weight despite significant reductions in pain and disability after successful ankle surgery,” Murray J. Penner, MD, said.

Penner and his team chose 145 patients who underwent ankle replacement or fusion from the Vancouver Prospective Ankle Reconstruction database. Inclusion criteria were 1-year minimum follow-up, successful surgical outcome defined by improved Ankle Osteoarthritis Scale (AOS) and no revision surgery. The investigators also selected patients with a BMI between 25.1 and 29.9, obese patients with a BMI between 30 and 34.9 and morbidly obese patients with a BMI >35.

The team excluded patients with diabetes with neuropathy or Charcot or major medical comorbidities which limited patients functionally, including major cardiovascular, respiratory, cerebrovascular or neuromuscular impairments. Patients with cognitive or psychiatric disease or debilitating hip, knee or spine arthritis were also excluded.

The study included 87 men and 58 women with a mean age of 61.5 years and a mean BMI of 29.2. Ninety patients underwent total ankle replacement and 55 patients underwent ankle fusion.

The team compared preoperative BMI to postoperative BMI at 6 months, 1 year, 2 years and 5 years. Penner said that patients with improved SF-36 or AOS scores postoperatively had no significant change in BMI when compared with preoperative BMIs.

“Physicians and patients should not assume weight loss will naturally follow successful ankle reconstruction,” Penner said.

Reference:

• Penner MJ, Pakzad H, Younger A, Wing KJ. Mean BMI in overweight and obese patients does not decrease after successful ankle reconstruction. Paper #70. Presented at the 2011 Annual Meeting of the American Orthopaedic Foot and Ankle Society. July 13-16. Keystone, Colo.
• Disclosure: Penner has no disclosures.

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