Should obese patients undergo bariatric surgery prior to a joint replacement? Two new studies done at the Hospital for Special Surgery in New York indicate that they should. The studies provided evidence that bariatric surgery prior to joint replacement is a cost-effective option to improve outcomes after hip or knee replacement.
The researchers compared the costs of two treatment protocols with two groups of patients, both of whom were morbidly obese and had advanced hip or knee osteoarthritis. One group received joint replacements immediately while members of the other group had weight loss surgery and waited for two years before receiving their joint replacements.
The investigators found that surgical weight loss prior to joint replacement emerged as a cost-effective option, from a public payer standpoint.
Emily Dodwell, M.D., the study’s lead investigator and an orthopedic surgeon at the Hospital for Special Surgery, said, “Up to 50 percent of hip replacements are performed in obese patients at some institutions. Obesity is associated with longer hospital stays, higher overall costs and higher failure rates, necessitating costly revision surgery.”
The report also quoted a spokesman for Arthritis Research UK who said: “It makes sense for people with arthritis who are about to undergo major surgery such as hip replacement to be an optimum weight prior to the operation. Post-operatively they will gain the most benefit if they do plenty of rehabilitation and exercise.”
