Losing Weight Helps Overweight Patients Reap Benefits of Joint Replacement Surgery

Patients who want to have the best results after having joint replacement surgery should try to shed any excess pounds they carry.

Although most patients who are overweight sincerely want to lose weight after joint replacement, research shows that an equal number of patients actually gain weight after hip or knee replacement. But those who were able to lose weight, fared the best, according to researchers from Hospital for Special Surgery. Not only did they see improvement in their joint function two years after surgery but also in their level of activity.

What’s uncertain is why some of the nearly 7,000 patients they followed tended to gain weight.

“Our findings represent the first report to present evidence that weight loss is associated with improved clinical outcomes, while weight gain is associated with inferior outcomes, although these results are really not surprising,” said Dr. Geoffrey Westrich, senior investigator and director of research, Adult Reconstruction and Joint Replacement at Hospital for Special Surgery.

The study looked at more than 3,000 knee replacement surgeries and nearly 3,900 hip replacement cases. The findings showed:

• Seventy-four percent of total knee replacement patients and 84 percent of total hip replacement patients did not demonstrate a change in BMI following surgery.
• Patients who underwent knee replacement were more likely to lose weight after surgery than those undergoing hip replacement.
• Patients who were obese prior to joint replacement were more likely to lose weight than those who were of normal weight or overweight, but not obese.
• Overweight or obese females undergoing joint replacement were more likely to lose weight than their male or normal weight counterparts.
• Patients with higher preoperative activity scores were more likely to maintain their weight than to gain or lose weight.

Researchers considered a number of other factors to see if they were associated with a change in weight, according to a news release from HSS. These factors included patient scores on preoperative surveys to assess pain, stiffness, and physical function; whether the patient was discharged to home or a rehabilitation facility; whether or not the patient smoked; and co-existing health problems such as diabetes, hypertension and depression. None of these factors had an effect on weight gain or loss after joint replacement.

Those who were able to lose weight after knee replacement surgery felt much better compared to those who stayed the same weight or gained. For knee and hip and replacement patients, gaining weight lead to more pain, less function and lower activity levels.

“Based on our findings, as physicians, we should convey to our patients the importance of maintaining good health and an appropriate weight, and we should help them in any way we can to achieve this goal,” Westrich said.

Source: Hospital for Special Surgery news release

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