Postoperative weight loss with anti-obesity medication may decrease risk of revision TJA
Key takeaways:
- Patients on anti-obesity medication who had weight loss within 1 year after TJA may be at decreased risk for revision.
- Researchers concluded anti-obesity medication may improve 5- and 10-year survivorship.
Published results showed patients with obesity who took anti-obesity medications and had postoperative weight loss within 1 year after total joint arthroplasty may be at significantly decreased risk for revision at 5 and 10 years.
“These results suggest that pharmacotherapy, with relatively safe, effective and sustainable weight loss, could be considered a strategy for improving implant survivorship of hip and knee replacements in the obese population,” Dongxing Xie, MD, PhD, from the department of orthopedics at Xiangya Hospital and Central South University in China, and colleagues wrote in the study.
Xie and colleagues performed a cohort study of data from patients with obesity (mean age, 64.7 years) who took anti-obesity medication, such as orlistat, sibutramine, glucagon-like peptide-1 receptor agonists and rimonabant, within 1 year after total hip or knee arthroplasty. Mean BMI was 37.6 kg/m2.
At baseline, Xie and colleagues stratified patients into three, matched treatment strategy cohorts to achieve weight gain or stable weight (n = 3,691); small to moderate weight loss, defined by weight loss of 2% to 10% of body weight (n = 3,691); or large weight loss, defined by weight loss of greater than 10% of body weight (n = 3,691) within 1 year after initiation of anti-obesity medication.
Among the cohorts, 1,729 patients in the weight gain or no loss cohort, 1,771 patients in the small to moderate weight loss cohort and 563 patients in the large weight loss cohort adhered to their assigned proportion of weight loss within 1 year after initiation of anti-obesity medications.
Xie and colleagues found weighted risk for revision at 5 years was 5.6% (n = 168) for the weight gain or no loss cohort, 4.4% (n = 125) for the small to moderate weight loss cohort and 3.7% (n = 86) for the large weight loss cohort. Compared with the weight gain or no loss cohort, the small to moderate weight loss cohort had a 25% decreased risk (HR = 0.75; 95% CI, 0.55-1.04) and the large weight loss cohort had a 43% decreased risk (HR = 0.57; 95% CI, 0.36-0.91) for revision at 5 years.
Xie and colleagues noted a similar pattern for weighted risk for revision at 10 years among the cohorts.
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