C. Polito1, X. Zhang2, J. Yang2, K. Spaniolas3, S. Sbayi1, A. Pryor1 1Northwell Health, Department Of Surgery, Manhasset, NEW YORK, USA 2Stony Brook Medicine, Department Of Family, Population, & Preventative Medicine, Stony Brook, NEW YORK, USA 3Stony Brook Medicine, Department Of Surgery, Stony Brook, NEW YORK, USA
Introduction: Obesity is associated with increased complication rates following lower extremity total joint arthroplasty (TJA). Bariatric surgery is a treatment for weight loss; however, there is conflicting evidence regarding the impact of prior bariatric surgery on TJA outcomes. This study will focus on the effect of different types of bariatric surgery prior to total knee arthroplasty (TKA) and total hip arthroplasty (THA).
Methods: In this retrospective study, patients who underwent TKA and THA between January 2009 and December 2018 were extracted from the New York Statewide Planning and Research Cooperative System (SPARCS) database. From this, patients who had a prior bariatric procedure at least 2 years before a TKA/THA were included in the study. Bariatric procedures included: Roux- en-Y gastric bypass (RYGB), laparoscopic sleeve gastrectomy (LSG), gastric band (LAGB), and other restrictive gastric procedures (Other). Outcomes included 90-day reoperation, 90-day readmission, in-hospital complications, discharge destination, and length of stay (LOS).
Results: 5,102 TKA records and 1,821 THA records were included. Patients who underwent LSG prior to TKA had the shortest LOS (LSG vs LAGB: ratio=0.90, 95% CI 0.83-0.97; LSG vs Other: ratio=0.82, 95% CI 0.75-0.90; LSG vs RYGB: ratio=0.90, 95% CI 0.84-0.97). Patients who underwent LSG prior to THA had a significantly lower risk of 90-day readmission compared with RYGB patients (OR=0.53, 95% CI 0.29-0.96). There were no significant associations between bariatric surgery type and other remaining outcomes for TKA and THA.
Conclusion: Overall, prior LSG has fewer poor surgical outcomes following TKA or THA.