title: Do patients lose weight after joint arthroplasty surgery? A systematic review.
abstract: BACKGROUND
  The ability of patients with a total joint arthroplasty (TJA) to lose weight after surgery has been investigated in a few studies with inconsistent results.
  
  
  OBJECTIVE
  We asked: (1) What is the quality of evidence of current published literature on postoperative weight trends for patients who have had a TJA? (2) Do patients lose any weight after TJA? (3) Do patients lose a clinically meaningful amount of weight after TJA?
  
  
  METHODS
  We conducted a systematic review of PubMed and the Cochrane Library. Studies were summarized according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement. Studies were reviewed for quality of evidence and limitations according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. Twelve studies were identified, one case-cohort study and 11 case series. Most studies were from single-surgeon or single-hospital series. Five studies included THAs and TKAs, four only THAs, and three only TKAs. We determined study type, level of evidence, inclusion criteria, procedures, proportion of patients who changed weight, body composition assessment, time of composition assessment, statistical analysis performed, and subgroup analysis conducted.
  
  
  RESULTS
  Owing to the observational nature of the studies and the serious limitations identified, all were considered very low quality according to GRADE criteria. Studies reported 14% to 49% of patients had some weight loss at least 1 year postoperatively.
  
  
  CONCLUSIONS
  We found no conclusive evidence that weight or body composition increases, decreases, or remains the same after TJA.
authors.affiliation: Joint Doctoral Program in Epidemiology, San Diego State University/University of California, 3033 Bunker Hill St., San Diego, CA 92109, USA. maria.cs.inacio@kp.org
authors.forename: Maria C S
authors.initials: MC
authors.lastname: Inacio
authors.forename: Donna
authors.initials: D
authors.lastname: Kritz-Silverstein
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Paxton
authors.forename: Donald C
authors.initials: DC
authors.lastname: Fithian
mesh_terms: D019643:Arthroplasty, Replacement; D001835:Body Weight; D006801:Humans; D011184:Postoperative Period; D015431:Weight Loss