Abstract
The impact of obesity on clinical outcomes following joint replacement procedures is resounding. Therefore, multiple strategies to achieve a substantial weight loss before surgery are needed in obese patients. The aim of the study was to test the effect of a fiber-enriched high carbohydrate (FEHC) diet on the reduction in body weight and pain in elderly obese patients undergoing total hip arthroplasty (THA). Sixty-one candidates for THA were included in our study. Prior to the procedure, the participants have been randomly assigned to a 3-month diet intervention (FEHC diet or free diet). Anthropometric measures and food questionnaires were collected at the enrollment and after 3 months. The Oxford Hip Score (OHS), the Hip disability and Osteoarthritis Outcome Score (HOOS) and the Western Ontario McMaster Universities OA Index (WOMAC) were administered at baseline and before surgery. A statistically significant variation of weight was found in the FEHC diet group (−3.7 kg, −4.4–−2.5) compared to the control group (−0.2 kg; −1.4–1.7; p < 0.0001), as well as significant improvements in the OHS (p < 0.0001), the HOOS (p < 0.0001) and the WOMAC (p < 0.0001) questionnaires. According to the results of the study, the FEHC diet in obese patients undergoing THA might help weight loss and improve related anthropometric parameters as well as hip function and pain.
Highlights
Obesity is one of the preventable causes of death and accounts for over 2.5 million deaths annually worldwide [1]
36 subjects were randomized to the fiber-enriched high carbohydrate (FEHC) diet, while 25 participants received the control free diet
The main characteristics of the population are shown in Table 1; the patients who followed the FEHC diet had significantly higher scores in the Hip disability and Osteoarthritis Outcome Score (HOOS) questionnaire at both baseline and follow-up times, and lower scores in the WOMAC questionnaire at follow-up as compared with the controls
Summary
Obesity is one of the preventable causes of death and accounts for over 2.5 million deaths annually worldwide [1]. The prevalence of obesity is expected to progressively rise with an increasing trend in the younger population. It is expected to determine an inevitable increase in hip osteoarthritis (OA) and an exponential increase in total hip arthroplasty (THA) procedures [2]. The higher mechanical load in weight-bearing joints negatively impact on joint homeostasis [3]. Metabolic disorders and potential systemic mediators related to obesity might contribute to joint degeneration and favor the development of OA [4,5]. THA is the third most commonly performed operation in Western countries [6]
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