Bariatric surgery before TKA cuts complications in obese patients

People with severe obesity and knee osteoarthritis are advised to attempt weight loss before total knee arthroplasty (TKA) as it could reduce complications of joint surgery, according to a study published online April 14 in JAMA Network Open.

Michelle M. Dowsey, Ph.D., from University of Melbourne in Australia, and colleagues examined whether outcomes are improved by undergoing bariatric surgery before TKA in adults with body mass index ≥35 kg/m² and end-stage osteoarthritis. Analysis included 82 patients waiting for TKA who were randomly assigned to undergo bariatric surgery (41 patients) or usual care (41 patients).

The researchers found that 14.6 percent of patients in the intervention group incurred a composite of complications versus 36.6 percent in the usual care group. Further, the between-group difference in body mass index at 12 months was −6.32, favoring the intervention group. Twelve participants in the intervention group declined TKA because of symptom improvement, while two participants in the usual care group declined TKA (difference, 24.4 percent).

"The findings suggest that people with severe obesity and knee osteoarthritis should seek to lose weight before considering TKA, and weight loss appears to reduce the complications of joint surgery," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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