Impact of bariatric surgery on total knee arthroplasty

Abstract

Obesity is a key risk factor for the development of knee osteoarthritis, and the incidence of obesity has more than quadrupled in the last 30 years. Total knee arthroplasty is used to treat severe knee osteoarthritis, and the need for initial total knee arthroplasties is predicted to expand rapidly. Total knee arthroplasty, on the other hand, is related with increased problems, longer hospital stays, and higher expenditures in obese individuals. The purpose of this study was to see if bariatric surgery affected knee symptoms in obese (BMI >30 kg/m2) adult patients. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, TRIP, BIOSIS-Previews, and reference lists of retrieved articles were thoroughly searched in English from the earliest available up to 30 December 2022 They included studies with a minimum follow-up of 4 months on the effect of surgically induced weight loss on knee symptoms in obese adult patients. Excluded were research investigating the impact of lipectomy or liposuction, as well as trials in which patients had already undergone total knee arthroplasty. This systematic review comprised 127 studies with a total of 22,229 patients. Despite the fact that several evaluation measures were utilized, an overall substantial reduction in knee pain was observed in 76% of the assessments. After bariatric surgery, all trials assessing the level of knee pain, physical function, and stiffness revealed a considerable improvement. For the majority of the included research, the quality of the evidence was extremely poor or very low, while it was moderate for one study. In obese adult patients, bariatric surgery followed by significant weight reduction is likely to improve knee pain, physical function, and stiffness. However, considering the existing data, high-quality research is required.