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      Obesity and the role of bariatric surgery in the surgical management of osteoarthritis of the hip and knee: a review of the literature

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          Abstract

          Obesity accelerates the development of osteoarthritis of the knee and hip by exerting deleterious effects on joints through both biomechanical and also systemic inflammatory changes. The objective of this review was to evaluate the impact of obesity on lower limb biomechanics and total joint arthroplasty outcomes, as well as weight changes after joint arthroplasty and the role of bariatric surgery among patients requiring joint arthroplasty. The currently published data indicate that weight loss increases swing time, stride length, gait speed, and lower extremity range of motion. Total joint arthroplasty improves pain and joint function, but does not induce significant weight loss in the majority of patients. Bariatric surgery improves gait biomechanics, and in the severely obese patient with osteoarthritis improves pain and joint function. The evidence for supporting bariatric surgery before total joint arthroplasty is limited to retrospective reports with conflicting results. Fundamental clinical questions remain regarding the optimal management of morbid obesity and lower extremity arthritis, which should be the focus of future collaborations across disciplines providing care to patients with both conditions.

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          Author and article information

          Journal
          Surgery for Obesity and Related Diseases
          Surgery for Obesity and Related Diseases
          Elsevier BV
          15507289
          January 2017
          January 2017
          : 13
          : 1
          : 111-118
          Article
          10.1016/j.soard.2016.09.011
          27865814
          ddc347ec-24f6-463e-bc6f-3e0a6859f643
          © 2017

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