Impact of Prior Metabolic and Bariatric Surgery on Outcomes of Total Knee and Total Hip Arthroplasty: A Systematic Review and Meta-analysis.
Systematic Review
The current study evaluated the effects of prior metabolic and bariatric surgery (MBS) on complications after total knee/hip arthroplasty (TKA/THA). We performed a meta-analysis to assess the impact of prior MBS on TKA/THA outcomes./r/nOur systematic search was conducted on PubMed, Embase, Scopus, and Web of Science until September 2024. Thirteen studies were included in total, one of which was an RCT, and the others were retrospective studies./r/nAccording to our findings, MBS was linked to decreased risk of peri-prosthetic joint infection in 853 MBS vs. 835 non-MBS patients (OR: 0.55, 95% CI : 0.31, 0.97, value: 0.04), deep venous thromboembolism in 1074 MBS vs. 11948 non-MBS patients (OR: 0.50, 95% CI: 0.28, 0.86, value: 0.01), and shorter length of hospital stay in 2,221 MBS vs. 12,201 non-MBS patients (mean difference: -0.42 days, 95% CI : -0.71, -0.13, value<0.001) after TKA/THA. Aseptic loosening, blood transfusion, peri-prosthetic fracture, postoperative manipulation, readmission, reoperation, dislocation, pulmonary thromboembolism, revision, and wound complications were not significantly associated with MBS./r/nMBS prior to TKA/THA can considerably reduce some post-operative complications, such as the risk of PJI, DVT, and LOS at the hospital. It can be offered to patients with severe obesity before undergoing TKA/THA.
