If you failed to lose some weight before your joint replacement surgery, do not give up. Losing weight following the surgery has clear benefits.
According to a study by Geoffrey Westrich, M.D., research director of the adult reconstruction and joint replacement service at New York’s Hospital for Special Surgery, patients who lost weight after knee surgery suffered less pain, enjoyed better function and exhibited higher activity levels than those who maintained the same weight or gained. Weight gain also led to poorer outcomes for hip replacement patients.
The paper, titled, “Weight Change after Hip and Knee Arthroplasty: Incidence, Predictors and Effects on Clinical Outcomes, ” was presented at the annual meeting of the American Academy of Orthopaedic Surgeons in New Orleans on March 14.
Previous studies provided conflicting evidence regarding whether patients lose or gain weight after lower extremity joint replacement, according to Dr. Westrich. And prior to his study, there was little research examining whether weight change after joint replacement was associated with a difference in clinical outcomes. HSS researchers aimed to answer these questions, and also see if there are factors that predispose patients to gain or lose weight after surgery.
Dr. Westrich and his colleagues reviewed 3, 036 knee and 3, 893 hip replacement surgeries and found the following;
• Seventy-four percent of total knee replacement patients and 84 percent of total hip replacement patients did not demonstrate a change in BMI following surgery.
• Patients who underwent knee replacement surgery were more likely to lose weight after surgery than those who had hip replacement surgery.
• Patients who were obese before their joint replacement surgery were MORE likely to lose weight than those patients who were either normal weight or overweight, but not obese.
• Overweight or obese females who had joint replacement surgery were more likely to lose weight than their male or normal weight counterparts.
• Patients with higher pre-operative activity scores were more likely to maintain their weight than to gain or lose weight.
Researchers considered a number of other factors to see if they were associated with a change in weight. These factors included patient scores on preoperative surveys to assess pain, stiffness, and physical function; whether the patient was discharged to home or a rehabilitation facility; whether or not the patient smoked; and co-existing health problems such as diabetes, hypertension and depression. None of these factors was determined to predispose patients to experiencing weight gain or loss after joint replacement.
Dr. Westrich and his colleagues reviewed the BMIs of nearly 7, 000 patients in the two years after their surgeries and found that most remained at the same weight levels. “We should convey to our patients the importance of maintaining good health and an appropriate weight, and we should help them in any way we can, ” said Westrich.
