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Obesity Surgery

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01-05-2018 | Original Contributions

Bariatric Surgery and Time to Total Joint Arthroplasty: Does It Affect Readmission and Complication Rates?

Authors: Ran Schwarzkopf, Jessica A. Lavery, Jessica Hooper, Manish Parikh, Heather T. Gold

Published in: Obesity Surgery | Issue 5/2018

Abstract

Background

Bariatric surgery is frequently recommended prior to total joint arthroplasty (TJA) for morbidly obese patients with end-stage arthropathy. Current published data on the efficacy of bariatric surgery for preoperative medical optimization has yielded mixed results, and the effect of time from bariatric surgery to TJA on the preoperative risk profile is not well defined. Our study evaluated the effect of time from bariatric surgery to TJA on 90-day complication and readmission rates.

Methods

We utilized the Healthcare Cost and Utilization Project (HCUP) California State Inpatient Database (SID) to identify patients who underwent TJA following bariatric surgery between 2007 and 2011. Primary endpoints were 90-day complication rates and all-cause 90-day readmission rates following TJA.

Results

We identified 330 cases of bariatric surgery followed by total hip arthroplasty (THA) and 1017 cases followed by total knee arthroplasty (TKA). There were no significant demographic differences among patients who underwent TJA greater than or less than 6 months after bariatric surgery. Patients undergoing THA more than 6 months after bariatric surgery were significantly less likely to be readmitted within 90 days for any cause. There was no association between time from bariatric surgery to THA or TKA and 90-day complications.

Discussion

Delaying THA at least 6 months after bariatric surgery may help reduce the rate of 90-day readmissions in this high-risk patient population. Arthroplasty surgeons recommending bariatric surgery as preoperative risk modification should consider the patient’s overall nutritional status, medical comorbidities, and overall response to surgery prior to booking for TJA.

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Title: Bariatric Surgery and Time to Total Joint Arthroplasty: Does It Affect Readmission and Complication Rates?
Authors: Ran Schwarzkopf
Jessica A. Lavery
Jessica Hooper
Manish Parikh
Heather T. Gold
Publication date: 01-05-2018
Publisher: Springer US
Published in: Obesity Surgery / Issue 5/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-017-3034-6

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Bariatric Surgery and Time to Total Joint Arthroplasty: Does It Affect Readmission and Complication Rates?

Abstract

Background

Methods

Results

Discussion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Discussion

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