A review of obesity and orthopaedic surgery: The critical issues

Obalum, D C; Fiberesima, F; Eyesan, Samuel Uwale; Ogo, Chidiebere N.; Nzew, C; Mijinyawa, Muhammad Sani

doi:10.4103/1117-1936.169667

Cited by 7 publications

(1 citation statement)

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“…Obesity and higher comorbidity scores were also found to be risk factors for postoperative complications in both QTR and PTR groups, which is consistent with prior reports [18, 20]. The effect of obesity on surgical outcomes has been well‐documented and could be related to issues associated with increased cardiopulmonary risks, nutrition and medication adjustments, and changes in instrumentation, surgical approach, and patient positioning [13, 23, 29]. Similarly, other comorbidities including diabetes mellitus, which is associated with a 100–300% increase in risk for additional diseases such as coronary artery disease, hypertension, and cerebrovascular accidents, have been shown to negatively influence surgical outcomes [10, 22].…”

Section: Discussionsupporting

confidence: 87%

Complications and re-operations after extensor mechanism repair surgery in a large cross-sectional cohort: females and tobacco-users at highest risk for adverse outcomes

Oeding

Alrabaa

Wong

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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PurposeThere is little information on patients most at risk for poor outcomes following surgical repair of extensor mechanism tendon injuries. The purpose of this study is to provide an epidemiological overview of patients undergoing patellar or quadriceps tendon repair and to assess the incidence of postoperative complications, readmissions, and revision repairs among this population. MethodsRetrospective data were obtained using the PearlDiver database for patellar tendon repair and quadriceps tendon repair patients between 2010 and 2020. Baseline demographics, incidences of 90‐day readmissions and postoperative complications, and reoperation rates were collected for each group. Multivariate logistic regression was performed to assess the predictive power of each demographic variable on the incidence of postoperative complications and reoperations. ResultsIn total, 1543 patients underwent patellar tendon repair and 601 underwent quadriceps tendon repair. Complications within 90‐days were observed in 33.7% of patients with patellar tendon repair and 39.2% of patients with quadriceps tendon repair. Reoperation rates were 4.2% and 4.8% for patellar tendon repair and quadriceps tendon repair, respectively. Females in both patellar tendon repair and quadriceps tendon repair groups were at significantly higher risk for post‐operative complications (patellar tendon repair OR 3.0, 95% CI 2.4–3.7; quadriceps tendon repair OR 2.9, 95% CI 1.9–4.6; p < 0.001 for both). Older age (p < 0.001), female gender (p < 0.001), CCI (p < 0.001), tobacco use (p < 0.001), and obesity (p < 0.01) were all predictors of experiencing at least one complication following patellar tendon repair. For quadriceps tendon repair, female gender (p < 0.001) and CCI (p < 0.001) were the strongest predictors of experiencing at least one complication, while older age, tobacco use, and obesity (p < 0.05 for all) were also significant independent predictors. ConclusionPatellar tendon repair patients are younger on average than quadriceps tendon repair patients. Although females are less likely to sustain extensor mechanism ruptures compared to males, females are significantly more likely to have at least one complication after quadriceps or patellar tendon repair. These findings may be used by surgeons, patients, and payors to understand who is most at risk for adverse outcomes following extensor mechanism repair surgery, resulting in earlier intervention and counseling to reduce the likelihood of a poor outcome following extensor mechanism repair surgery. Level of evidenceLevel III.

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Section: Discussionsupporting

confidence: 87%

Complications and re-operations after extensor mechanism repair surgery in a large cross-sectional cohort: females and tobacco-users at highest risk for adverse outcomes

Oeding

Alrabaa

Wong

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Pharmacotherapy as an Augmentation to Bariatric Surgery for Obesity

Horváth,

Mráz,

Jude

et al. 2024

Drugs

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A global obesity pandemic is one of the most significant health threats worldwide owing to its close association with numerous comorbidities such as type 2 diabetes mellitus, arterial hypertension, dyslipidemia, heart failure, cancer and many others. Obesity and its comorbidities lead to a higher rate of cardiovascular complications, heart failure and increased cardiovascular and overall mortality. Bariatric surgery is at present the most potent therapy for obesity, inducing a significant weight loss in the majority of patients. In the long-term, a substantial proportion of patients after bariatric surgery experience a gradual weight regain that may, in some, reach up to a presurgical body weight. As a result, anti-obesity pharmacotherapy may be needed in some patients after bariatric surgery to prevent the weight regain or to further potentiate weight loss. This article provides an overview of the use of anti-obesity medications as an augmentation to bariatric surgery for obesity. Despite relatively limited published data, it can be concluded that anti-obesity medication can serve as an effective adjunct therapy to bariatric surgery to help boost post-bariatric weight loss or prevent weight regain.

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