, Volume 471, Issue 1, pp 291-298

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

Topic
General

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.

Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.
This work was performed in the Joint Doctoral Program in Epidemiology at San Diego State University/University of California, San Diego, San Diego, CA, USA