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Published in: Clinical Orthopaedics and Related Research® 1/2013

01-01-2013 | Survey

Do Patients Lose Weight After Joint Arthroplasty Surgery? A Systematic Review

Authors: Maria C. S. Inacio, MS, Donna Kritz-Silverstein, PhD, Elizabeth W. Paxton, MA, Donald C. Fithian, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 1/2013

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Abstract

Background

The ability of patients with a total joint arthroplasty (TJA) to lose weight after surgery has been investigated in a few studies with inconsistent results.

Questions/Purposes

We asked: (1) What is the quality of evidence of current published literature on postoperative weight trends for patients who have had a TJA? (2) Do patients lose any weight after TJA? (3) Do patients lose a clinically meaningful amount of weight after TJA?

Methods

We conducted a systematic review of PubMed and the Cochrane Library. Studies were summarized according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement. Studies were reviewed for quality of evidence and limitations according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. Twelve studies were identified, one case-cohort study and 11 case series. Most studies were from single-surgeon or single-hospital series. Five studies included THAs and TKAs, four only THAs, and three only TKAs. We determined study type, level of evidence, inclusion criteria, procedures, proportion of patients who changed weight, body composition assessment, time of composition assessment, statistical analysis performed, and subgroup analysis conducted.

Results

Owing to the observational nature of the studies and the serious limitations identified, all were considered very low quality according to GRADE criteria. Studies reported 14% to 49% of patients had some weight loss at least 1 year postoperatively.

Conclusions

We found no conclusive evidence that weight or body composition increases, decreases, or remains the same after TJA.
Literature
1.
go back to reference Abu-Rajab RB, Findlay H, Young D, Jones B, Ingram R. Weight changes following lower limb arthroplasty: a prospective observational study. Scott Med J. 2009;54:26–28.PubMedCrossRef Abu-Rajab RB, Findlay H, Young D, Jones B, Ingram R. Weight changes following lower limb arthroplasty: a prospective observational study. Scott Med J. 2009;54:26–28.PubMedCrossRef
2.
go back to reference Aderinto J, Brenkel IJ, Chan P. Weight change following total hip replacement: a comparison of obese and non-obese patients. Surgeon. 2005;3:269–272, 305. Aderinto J, Brenkel IJ, Chan P. Weight change following total hip replacement: a comparison of obese and non-obese patients. Surgeon. 2005;3:269–272, 305.
5.
go back to reference Balshem H, Helfand M, Schunemann HJ, Oxman AD, Kunz R, Brozek J, Vist GE, Falck-Ytter Y, Meerpohl J, Norris S, Guyatt GH. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol. 2011;64:401–406.PubMedCrossRef Balshem H, Helfand M, Schunemann HJ, Oxman AD, Kunz R, Brozek J, Vist GE, Falck-Ytter Y, Meerpohl J, Norris S, Guyatt GH. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol. 2011;64:401–406.PubMedCrossRef
6.
go back to reference Birrell F, Johnell O, Silman A. Projecting the need for hip replacement over the next three decades: influence of changing demography and threshold for surgery. Ann Rheum Dis. 1999;58:569–572.PubMedCrossRef Birrell F, Johnell O, Silman A. Projecting the need for hip replacement over the next three decades: influence of changing demography and threshold for surgery. Ann Rheum Dis. 1999;58:569–572.PubMedCrossRef
7.
go back to reference Blagojevic M, Jinks C, Jeffery A, Jordan KP. Risk factors for onset of osteoarthritis of the knee in older adults: a systematic review and meta-analysis. Osteoarthritis Cartilage. 2010;18:24–33.PubMedCrossRef Blagojevic M, Jinks C, Jeffery A, Jordan KP. Risk factors for onset of osteoarthritis of the knee in older adults: a systematic review and meta-analysis. Osteoarthritis Cartilage. 2010;18:24–33.PubMedCrossRef
8.
go back to reference Cram P, Lu X, Kaboli PJ, Vaughan-Sarrazin MS, Cai X, Wolf BR, Li Y. Clinical characteristics and outcomes of Medicare patients undergoing total hip arthroplasty, 1991–2008. JAMA. 2011;305:1560–1567.PubMedCrossRef Cram P, Lu X, Kaboli PJ, Vaughan-Sarrazin MS, Cai X, Wolf BR, Li Y. Clinical characteristics and outcomes of Medicare patients undergoing total hip arthroplasty, 1991–2008. JAMA. 2011;305:1560–1567.PubMedCrossRef
9.
go back to reference Dixon T, Shaw M, Ebrahim S, Dieppe P. Trends in hip and knee joint replacement: socioeconomic inequalities and projections of need. Ann Rheum Dis. 2004;63:825–830.PubMedCrossRef Dixon T, Shaw M, Ebrahim S, Dieppe P. Trends in hip and knee joint replacement: socioeconomic inequalities and projections of need. Ann Rheum Dis. 2004;63:825–830.PubMedCrossRef
10.
go back to reference Donovan J, Dingwall I, McChesney S. Weight change 1 year following total knee or hip arthroplasty. ANZ J Surg. 2006;76:222–225.PubMedCrossRef Donovan J, Dingwall I, McChesney S. Weight change 1 year following total knee or hip arthroplasty. ANZ J Surg. 2006;76:222–225.PubMedCrossRef
11.
go back to reference Dowsey MM, Liew D, Stoney JD, Choong PF. The impact of obesity on weight change and outcomes at 12 months in patients undergoing total hip arthroplasty. Med J Aust. 2010;193:17–21.PubMed Dowsey MM, Liew D, Stoney JD, Choong PF. The impact of obesity on weight change and outcomes at 12 months in patients undergoing total hip arthroplasty. Med J Aust. 2010;193:17–21.PubMed
12.
go back to reference Dowsey MM, Liew D, Stoney JD, Choong PF. The impact of pre-operative obesity on weight change and outcome in total knee replacement: a prospective study of 529 consecutive patients. J Bone Joint Surg Br. 2010;92:513–520.PubMedCrossRef Dowsey MM, Liew D, Stoney JD, Choong PF. The impact of pre-operative obesity on weight change and outcome in total knee replacement: a prospective study of 529 consecutive patients. J Bone Joint Surg Br. 2010;92:513–520.PubMedCrossRef
13.
go back to reference Flugsrud GB, Nordsletten L, Espehaug B, Havelin LI, Engeland A, Meyer HE. The impact of body mass index on later total hip arthroplasty for primary osteoarthritis: a cohort study in 1.2 million persons. Arthritis Rheum. 2006;54:802–807.PubMedCrossRef Flugsrud GB, Nordsletten L, Espehaug B, Havelin LI, Engeland A, Meyer HE. The impact of body mass index on later total hip arthroplasty for primary osteoarthritis: a cohort study in 1.2 million persons. Arthritis Rheum. 2006;54:802–807.PubMedCrossRef
15.
go back to reference Guyatt GH, Oxman AD, Vist G, Kunz R, Brozek J, Alonso-Coello P, Montori V, Akl EA, Djulbegovic B, Falck-Ytter Y, Norris SL, Williams JW Jr, Atkins D, Meerpohl J, Schünemann HJ. GRADE guidelines: 4. Rating the quality of evidence—study limitations (risk of bias). J Clin Epidemiol. 2011;64:407–415. Guyatt GH, Oxman AD, Vist G, Kunz R, Brozek J, Alonso-Coello P, Montori V, Akl EA, Djulbegovic B, Falck-Ytter Y, Norris SL, Williams JW Jr, Atkins D, Meerpohl J, Schünemann HJ. GRADE guidelines: 4. Rating the quality of evidence—study limitations (risk of bias). J Clin Epidemiol. 2011;64:407–415.
16.
go back to reference Harms S, Larson R, Sahmoun AE, Beal JR. Obesity increases the likelihood of total joint replacement surgery among younger adults. Int Orthop. 2007;31:23–26.PubMedCrossRef Harms S, Larson R, Sahmoun AE, Beal JR. Obesity increases the likelihood of total joint replacement surgery among younger adults. Int Orthop. 2007;31:23–26.PubMedCrossRef
17.
go back to reference Heisel C, Silva M, dela Rosa MA, Schmalzried TP. The effects of lower-extremity total joint replacement for arthritis on obesity. Orthopedics. 2005;28:157–159.PubMed Heisel C, Silva M, dela Rosa MA, Schmalzried TP. The effects of lower-extremity total joint replacement for arthritis on obesity. Orthopedics. 2005;28:157–159.PubMed
18.
go back to reference Jain SA, Roach RT, Travlos J. Changes in body mass index following primary elective total hip arthroplasty: correlation with outcome at 2 years. Acta Orthop Belg. 2003;69:421–425.PubMed Jain SA, Roach RT, Travlos J. Changes in body mass index following primary elective total hip arthroplasty: correlation with outcome at 2 years. Acta Orthop Belg. 2003;69:421–425.PubMed
19.
go back to reference Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89:780–785.PubMedCrossRef Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89:780–785.PubMedCrossRef
20.
go back to reference Kurtz SM, Lau E, Ong K, Zhao K, Kelly M, Bozic KJ. Future young patient demand for primary and revision joint replacement: national projections from 2010 to 2030. Clin Orthop Relat Res. 2009;467:2606–2612.PubMedCrossRef Kurtz SM, Lau E, Ong K, Zhao K, Kelly M, Bozic KJ. Future young patient demand for primary and revision joint replacement: national projections from 2010 to 2030. Clin Orthop Relat Res. 2009;467:2606–2612.PubMedCrossRef
21.
go back to reference Kurtz SM, Ong KL, Lau E, Bozic KJ, Berry D, Parvizi J. Prosthetic joint infection risk after TKA in the Medicare population. Clin Orthop Relat Res. 2010;468:52–56.PubMedCrossRef Kurtz SM, Ong KL, Lau E, Bozic KJ, Berry D, Parvizi J. Prosthetic joint infection risk after TKA in the Medicare population. Clin Orthop Relat Res. 2010;468:52–56.PubMedCrossRef
22.
go back to reference Lachiewicz AM, Lachiewicz PF. Weight and activity change in overweight and obese patients after primary total knee arthroplasty. J Arthroplasty. 2008;23:33–40.PubMedCrossRef Lachiewicz AM, Lachiewicz PF. Weight and activity change in overweight and obese patients after primary total knee arthroplasty. J Arthroplasty. 2008;23:33–40.PubMedCrossRef
23.
go back to reference Mantilla CB, Horlocker TT, Schroeder DR, Berry DJ, Brown DL. Risk factors for clinically relevant pulmonary embolism and deep venous thrombosis in patients undergoing primary hip or knee arthroplasty. Anesthesiology. 2003;99:552–560; discussion 5A.PubMedCrossRef Mantilla CB, Horlocker TT, Schroeder DR, Berry DJ, Brown DL. Risk factors for clinically relevant pulmonary embolism and deep venous thrombosis in patients undergoing primary hip or knee arthroplasty. Anesthesiology. 2003;99:552–560; discussion 5A.PubMedCrossRef
24.
go back to reference McMahon M, Block JA. The risk of contralateral total knee arthroplasty after knee replacement for osteoarthritis. J Rheumatol. 2003;30:1822–1824.PubMed McMahon M, Block JA. The risk of contralateral total knee arthroplasty after knee replacement for osteoarthritis. J Rheumatol. 2003;30:1822–1824.PubMed
25.
go back to reference Memtsoudis SG, Della Valle AG, Besculides MC, Gaber L, Laskin R. Trends in demographics, comorbidity profiles, in-hospital complications and mortality associated with primary knee arthroplasty. J Arthroplasty. 2009;24:518–527.PubMedCrossRef Memtsoudis SG, Della Valle AG, Besculides MC, Gaber L, Laskin R. Trends in demographics, comorbidity profiles, in-hospital complications and mortality associated with primary knee arthroplasty. J Arthroplasty. 2009;24:518–527.PubMedCrossRef
26.
go back to reference Middleton FR, Boardman DR. Total hip arthroplasty does not aid weight loss. Ann R Coll Surg Engl. 2007;89:288–291.PubMedCrossRef Middleton FR, Boardman DR. Total hip arthroplasty does not aid weight loss. Ann R Coll Surg Engl. 2007;89:288–291.PubMedCrossRef
27.
go back to reference Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.PubMedCrossRef Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.PubMedCrossRef
29.
go back to reference Ong KL, Kurtz SM, Lau E, Bozic KJ, Berry DJ, Parvizi J. Prosthetic joint infection risk after total hip arthroplasty in the Medicare population. J Arthroplasty. 2009;24(6 suppl):105–109.PubMedCrossRef Ong KL, Kurtz SM, Lau E, Bozic KJ, Berry DJ, Parvizi J. Prosthetic joint infection risk after total hip arthroplasty in the Medicare population. J Arthroplasty. 2009;24(6 suppl):105–109.PubMedCrossRef
30.
go back to reference Sadr Azodi O, Adami J, Lindstrom D, Eriksson KO, Wladis A, Bellocco R. High body mass index is associated with increased risk of implant dislocation following primary total hip replacement: 2,106 patients followed for up to 8 years. Acta Orthop. 2008;79:141–147.PubMedCrossRef Sadr Azodi O, Adami J, Lindstrom D, Eriksson KO, Wladis A, Bellocco R. High body mass index is associated with increased risk of implant dislocation following primary total hip replacement: 2,106 patients followed for up to 8 years. Acta Orthop. 2008;79:141–147.PubMedCrossRef
31.
go back to reference Samson AJ, Mercer GE, Campbell DG. Total knee replacement in the morbidly obese: a literature review. ANZ J Surg. 2010;80:595–599.PubMedCrossRef Samson AJ, Mercer GE, Campbell DG. Total knee replacement in the morbidly obese: a literature review. ANZ J Surg. 2010;80:595–599.PubMedCrossRef
32.
go back to reference Santaguida PL, Hawker GA, Hudak PL, Glazier R, Mahomed NN, Kreder HJ, Coyte PC, Wright JG. Patient characteristics affecting the prognosis of total hip and knee joint arthroplasty: a systematic review. Can J Surg. 2008;51:428–436.PubMed Santaguida PL, Hawker GA, Hudak PL, Glazier R, Mahomed NN, Kreder HJ, Coyte PC, Wright JG. Patient characteristics affecting the prognosis of total hip and knee joint arthroplasty: a systematic review. Can J Surg. 2008;51:428–436.PubMed
33.
go back to reference Skytta ET, Jarkko L, Antti E, Huhtala H, Ville R. Increasing incidence of hip arthroplasty for primary osteoarthritis in 30- to 59-year-old patients. Acta Orthop. 2011;82:1–5.PubMedCrossRef Skytta ET, Jarkko L, Antti E, Huhtala H, Ville R. Increasing incidence of hip arthroplasty for primary osteoarthritis in 30- to 59-year-old patients. Acta Orthop. 2011;82:1–5.PubMedCrossRef
34.
go back to reference Stets K, Koehler SM, Bronson W, Chen M, Yang K, Bronson M. Weight and body mass index change after total joint arthroplasty. Orthopedics. 2010;33:386.PubMed Stets K, Koehler SM, Bronson W, Chen M, Yang K, Bronson M. Weight and body mass index change after total joint arthroplasty. Orthopedics. 2010;33:386.PubMed
35.
go back to reference Sturmer T, Gunther KP, Brenner H. Obesity, overweight and patterns of osteoarthritis: the Ulm Osteoarthritis Study. J Clin Epidemiol. 2000;53:307–313.PubMedCrossRef Sturmer T, Gunther KP, Brenner H. Obesity, overweight and patterns of osteoarthritis: the Ulm Osteoarthritis Study. J Clin Epidemiol. 2000;53:307–313.PubMedCrossRef
36.
go back to reference Woodruff MJ, Stone MH. Comparison of weight changes after total hip or knee arthroplasty. J Arthroplasty. 2001;16:22–24.PubMedCrossRef Woodruff MJ, Stone MH. Comparison of weight changes after total hip or knee arthroplasty. J Arthroplasty. 2001;16:22–24.PubMedCrossRef
37.
go back to reference Zeni JA Jr, Snyder-Mackler L. Most patients gain weight in the 2 years after total knee arthroplasty: comparison to a healthy control group. Osteoarthritis Cartilage. 2010;18:510–514.PubMedCrossRef Zeni JA Jr, Snyder-Mackler L. Most patients gain weight in the 2 years after total knee arthroplasty: comparison to a healthy control group. Osteoarthritis Cartilage. 2010;18:510–514.PubMedCrossRef
Metadata
Title
Do Patients Lose Weight After Joint Arthroplasty Surgery? A Systematic Review
Authors
Maria C. S. Inacio, MS
Donna Kritz-Silverstein, PhD
Elizabeth W. Paxton, MA
Donald C. Fithian, MD
Publication date
01-01-2013
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 1/2013
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-012-2537-7

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