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Weight change following TKA, THA affects outcome
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Patients who lose weight after joint replacement surgery have better clinical outcomes and activity levels, according to data presented at the American Academy of Orthopaedic Surgeons Annual Meeting.
“Our findings represent the first report to present evidence that weight loss is associated with improved clinical outcomes, while weight gain is associated with inferior outcomes, although these results are not really surprising,” Geoffrey Westrich, MD, senior investigator and director of research, Adult Reconstruction and Joint Replacement at Hospital for Special Surgery, stated in a Hospital for Special Surgery press release.
Using the Hospital for Special Surgery database, Westrich and colleagues studied the 2-year change in body mass indices (BMI) for 3,036 patients who had total knee arthroplasty (TKA) and 3,893 patients who had total hip arthroplasty (THA) to relieve osteoarthritis. Significant weight gain or loss was defined as a 5% change in BMI.
The researchers found that 74% of patients who had TKA and 84% of patients who had THA did not have a change in postoperative BMI. Patients who had TKA were more likely to lose weight postoperatively than patients who had THA. Additionally, patients who are obese prior to surgery were more likely to lose weight than patients who were of normal weight or overweight, but not obese. Overweight or obese women who had joint replacement surgery were more likely to lose weight that their male or normal weight counterparts.
Researchers also found that patients who had TKA and lost weight postoperatively had better Physical Component Scores (PCS) and Lower Extremity Activity Scores (LEAS) compared to patients who maintained or gained weight after surgery. Weight gain was linked to poorer PCS and LEAS scores for patients in both groups.
Reference:
Ast M. Paper #724. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 11-15, 2014; New Orleans.
Disclosure: Westrich receives royalties from Exactech Inc., is a paid consultant for and receives research support from DJ Orthopaedics, Exactech Inc. and Stryker.