Does Prior Bariatric Surgery Affect Implant Survivorship and Complications Following Primary Total Hip Arthroplasty/Total Knee Arthroplasty?

Lee, Gwo Chin; Ong, Kevin; Baykal, Doruk; Lau, Edmund; Malkani, Arthur L.

doi:10.1016/j.arth.2018.01.064

Cited by 30 publications

(17 citation statements)

References 19 publications

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“…Infection was the most common reason for reoperation and revision. Also Lee et al (2018) found an increased risk of revision in 70 patients having a BS before TKA within 2 years compared with a cohort of patients with chronic metabolic conditions, but found no increased risk of revision due to infection. Inacio et al (2014) found no difference in risk of revision in 62 BS patients operated on with a TKA within 2 years after the BS as compared with 2,616 TKA patients without BS.…”

Section: Discussionmentioning

confidence: 89%

Bariatric surgery prior to total knee arthroplasty is not associated with lower risk of revision: a register-based study of 441 patients

et al. 2020

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Section: Discussionmentioning

confidence: 89%

Bariatric surgery prior to total knee arthroplasty is not associated with lower risk of revision: a register-based study of 441 patients

et al. 2020

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“…Outcomes studied included early (in-hospital and 30-day) complications, 90-day complications, 1- or 2-year complications, mortality rates, revision rates, and LOS. Of the 13 studies included in this review, 5 (38%) analyzed both THA and TKA after BS [15, 17, 24, 28, 31], while 7 (54%) focused exclusively on TKA [19, 22, 29, 30, 36, 37, 43]. One paper (8%) focused solely on THA [42].…”

Section: Resultsmentioning

confidence: 99%

“…The average MINORS score was 17.6 (73.3%; range 8 to 21). Among the selected studies, three (23.1%) denote reduction in BMI between BS and TJA [22, 31, 42], while 10 (76.9%) did not mention changes in BMI [15, 17, 19, 20, 24, 28, 29, 36, 37, 43].…”

Section: Resultsmentioning

confidence: 99%

“…All studies reported post-operative complications, most commonly at less than 30 days [15, 20, 24, 28, 29] or 90 days [15, 17, 20, 24, 29, 36, 37, 43]. Cutoffs of 1 year [17, 19, 20], 2 years [19, 29, 42], or 10 years [42] were reported in five studies (38.5%), while two studies (15.4%) did not provide a specific time frame for when complications occurred [22, 31].…”

Section: Resultsmentioning

confidence: 99%

“…Ten studies (76.9%) reported revision rates [15, 17, 19, 20, 22, 24, 28, 29, 31, 36]. Five studies [15, 20, 24, 28, 31] found no increase in re-interventions for patients who underwent BS before TKA.…”

Section: Resultsmentioning

confidence: 99%

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The Effect of Bariatric Surgery Prior to Lower-Extremity Total Joint Arthroplasty: A Systematic Review

Cohen

Malahias

et al. 2019

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background Obesity is an independent risk factor for osteoarthritis and has been associated with increased rate of complications following lower-extremity total joint arthroplasty (TJA). Bariatric surgery (BS) is a surgical option for weight loss and for reducing obesity-related comorbidities in morbidly obese patients. Purpose/Questions The goal of this systematic review was to answer the following questions: (1) Does BS prior to TJA correlate with lower post-operative complication rates in morbidly obese patients undergoing TJA? (2) Does BS have an impact on revision rates following TJA? Methods Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and checklist, a systematic review of medical databases (PubMed/ MEDLINE, Cochrane Library, Web of Science, and Clinicaltrials.gov ) was undertaken for articles published in English from January 1990 to September 2018. Inclusion criteria were studies that included at least ten patients who underwent BS prior to TJA, collected data on complications or other outcomes, and followed patients for at least 90 days after TJA. A descriptive and critical analysis of the results was performed. Results From 799 studies, 13 met inclusion criteria. A total of 11,770 patients who had undergone bariatric surgery prior to TJA were analyzed. The quality of the evidence ranged between moderate and high. There was no consensus on the effect of previous BS on early- to short-term outcomes reported after TJA. Conclusion The literature remains conflicted on the impact of BS prior to TJA on early, short-term, and long-term complications after TJA. Additional well-matched, observational studies may further our understanding of the impact of BS prior to TJA on outcomes. In particular the effect of various types of BS prior to TJA on outcomes has yet to be elucidated. Ideally, prospective studies with higher level of evidence will be more definitive on the effects of BS prior to TJA. Prospero Registration Number: CRD42016043025. Electronic supplementary material The online version of this article (10.1007/s11420-019-09674-2) contains supplementary material, which is available to authorized users.

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New developments and future challenges in prevention, diagnosis, and treatment of prosthetic joint infection

Ricciardi

Muthukrishnan

Masters

et al. 2020

Journal Orthopaedic Research

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Prosthetic joint infection (PJI) is a devastating complication that results in substantial costs to society and patient morbidity. Advancements in our knowledge of this condition have focused on prevention, diagnosis, and treatment, in order to reduce rates of PJI and improve patient outcomes. Preventive measures such as optimization of patient comorbidities, and perioperative antibiotic usage are intensive areas of current clinical research to reduce the rate of PJI. Improved diagnostic tests such as synovial fluid (SF) α‐defensin enzyme‐linked immunosorbent assay, and nucleic acid‐based tests for serum, SF, and tissue cultures, have improved diagnostic accuracy and organism identification. Increasing the diversity of available antibiotic therapy, immunotherapy, and alternative implant coatings remain promising treatments to improve infection eradication in the setting of PJI.

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Does Prior Bariatric Surgery Affect Implant Survivorship and Complications Following Primary Total Hip Arthroplasty/Total Knee Arthroplasty?

Cited by 30 publications

References 19 publications

Bariatric surgery prior to total knee arthroplasty is not associated with lower risk of revision: a register-based study of 441 patients

Bariatric surgery prior to total knee arthroplasty is not associated with lower risk of revision: a register-based study of 441 patients

The Effect of Bariatric Surgery Prior to Lower-Extremity Total Joint Arthroplasty: A Systematic Review

New developments and future challenges in prevention, diagnosis, and treatment of prosthetic joint infection

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