The risk of surgical site infection and re-admission in obese patients undergoing total joint replacement who lose weight before surgery and keep it off post-operatively

Bone Joint J. 2014 May;96-B(5):629-35. doi: 10.1302/0301-620X.96B5.33136.

Abstract

This study evaluated whether obese patients who lost weight before their total joint replacement and kept it off post-operatively were at lower risk of surgical site infection (SSI) and re-admission compared with those who remained the same weight. We reviewed 444 patients who underwent a total hip replacement and 937 with a total knee replacement who lost weight pre-operatively and sustained their weight loss after surgery. After adjustments, patients who lost weight before a total hip replacement and kept it off post-operatively had a 3.77 (95% confidence interval (CI) 1.59 to 8.95) greater likelihood of deep SSIs and those who lost weight before a total knee replacement had a 1.63 (95% CI 1.16 to 2.28) greater likelihood of re-admission compared with the reference group. These findings raise questions about the safety of weight management before total replacement of the hip and knee joints.

Keywords: Hip replacement; Knee replacement; Obesity; Weight loss; Weight management.

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Hip
  • Arthroplasty, Replacement, Knee
  • Body Mass Index
  • Comorbidity
  • Female
  • Hip Prosthesis / adverse effects*
  • Humans
  • Knee Prosthesis / adverse effects*
  • Male
  • Middle Aged
  • Obesity / complications*
  • Obesity / epidemiology
  • Obesity / physiopathology
  • Patient Readmission / statistics & numerical data*
  • Preoperative Period
  • Prosthesis-Related Infections / epidemiology
  • Prosthesis-Related Infections / etiology*
  • Registries
  • Retrospective Studies
  • Risk Assessment / methods
  • United States / epidemiology
  • Weight Loss*