Lower BMI at time of surgery associated with improved functional outcomes after TJA
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Lower BMI at the time of surgery was associated with increased functional improvements for patients undergoing total joint arthroplasty, thus patients should focus on optimizing preoperative BMI, according to published results.
To determine the effect of postoperative weight change on outcomes after TJA, Laura A. Stock, MS, and colleagues retrospectively analyzed data on 988 patients who underwent total hip arthroplasty or total knee arthroplasty at a single institution’s joint arthroplasty center. According to the study, patients were classified by a 5% change in BMI. A reduction in BMI of greater than or equal to 5% was categorized as weight loss, an increase in BMI of greater than or equal to 5% was categorized as weight gain and a BMI change of less than 5% in gain or loss was categorized as unchanged.
Outcomes measures included Patient-Reported Outcomes Measurement Information System physical function (PROMIS-PF) scores and BMI. Researchers analyzed mixed-effect models to determine predictors of change in functional scores during the postoperative follow-up periods of 0 to 3 months, 3 to 6 months and 6 to 12 months.
Overall, 43.1% of patients underwent THA and 56.9% of patients underwent TKA. Stock and colleagues found that 92% of patients had no change in BMI at 0 to 3 months postoperatively; 82% had no change in BMI at 3 to 6 months postoperatively; and 80% of patients had no change in BMI at 6 to 12 months postoperatively. Similar and significant improvements in PROMIS-PF scores were observed across all weight change groups; however, researchers noted patients with a lower BMI at the time of surgery saw the greatest improvements in PROMIS-PF scores in both the THA and TKA cohorts.
“These results demonstrate most patients do not experience substantial changes in weight following TJA,” Stock and colleagues wrote in the study. “Lower BMIs at the time of surgery were associated with an increased functional improvement, suggesting that reducing BMI prior to surgery should be prioritized over postoperative weight loss to improve outcomes of TKA and THA,” they added.
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