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Bariatric Surgery Before Total Knee Replacement Improves Outcomes and is Cost Effective

posted by Admin User at 2016-02-12 14:43:00


Total knee arthroplasty in morbidly obese patients prior to bariatric surgery is linked to a reduction in costs and post-surgery complications according to a new study published in the Journal of Bone and Joint Surgery. This is good news for obese patients with end-stage osteoarthritis as previous research associates obesity and total knee arthroplasty with high costs and adverse outcomes after the procedure. 
"We know that bariatric surgery can be an effective treatment for morbid obesity, reducing a patient's excess weight. In addition, the surgery also reduces the burden of co-morbidities, like diabetes and high blood pressure, and may extend a patient's life span," said Alexander McLawhorn, MD, MBA - orthopedic surgeon and lead article author. "What we didn't know was whether or not it is cost effective to recommend bariatric surgery to achieve weight loss and improve preoperative health prior to joint replacement."
Researchers analysed previously published data on obesity, bariatric surgery and total knee replacement (TKR) to compare the costs and outcomes of TKR on an obese patient without any weight loss prior to the knee surgery vs those that had TKR two years after bariatric surgery. The results showed the bariatric surgery group of TKR patients were more likely to enjoy improved quality-of-life vs those who had the TKR without prior weight loss surgery. Effectiveness of the TKR was found to be lower in people who did not have bariatric surgery prior to the procedure. For independent variables, results were stable across a broad range of values. 
"We found that successful bariatric surgery performed two years before TKR could be a cost-effective treatment strategy for morbidly obese patients with end-stage arthritis," said Dr. McLawhorn. "While there remains some uncertainty in terms of the precise effects of bariatric surgery on knee osteoarthritis and total knee replacement, our model summarizes what is known about the clinical effects and costs of obesity, bariatric surgery and total knee replacement…The results of this study may help surgeons in counseling morbidly obese patients with knee osteoarthritis, and trying to come up with an individualized treatment plan that includes optimization of overall health, nutrition and weight prior to knee replacement”.
 
posted at: 2016-02-12 14:43:00, last updated: 2016-02-12 14:43:45
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