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.
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.
Kaiser Permanente, Department of Surgical Outcomes and Analysis, 8954 Rio San Diego Drive, Suite 406, San Diego, California, 92108, USA.
M C S
MC
Inacio
D
D
Kritz-Silverstein
R
R
Raman
C A
CA
Macera
J F
JF
Nichols
R A
RA
Shaffer
D C
DC
Fithian
D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D010359:Patient Readmission / Q000706:statistics & numerical data*; D057234:Preoperative Period; D016459:Prosthesis-Related Infections / Q000453:epidemiology / Q000209:etiology*; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D014481:United States / Q000453:epidemiology; D015431:Weight Loss
Hip replacement; Knee replacement; Obesity; Weight loss; Weight management