Bariatric Surgery before Hip Surgery

hip replacement weight lossA new study from the Edinburgh Royal Infirmary in the UK revealed that obese patients have far more complications after hip surgery than normal weight patients. The study found that about one out of five overweight patients suffer complications, such as infections or dislocation, after a hip operation, adding increased costs, further surgeries and longer stays in the hospital.  According to an article about the study published by Scotsman News, some surgeons now believe that, in some cases, patients should be offered weight-loss surgery before having a hip replaced, to increase the chances of it being successful.

The study consisted of patients with osteoarthritis who had hip replacement surgery, comparing 53 obese patients with 53 others of a normal weight. The patients were followed for five years to examine the outcomes and recuperation after surgery. The key finding was that 22 per cent of obese patients suffered complications after the operation, compared with only 5 per cent of non-obese patients, with the complications including dislocation of the hip as well as superficial and deep infections.

The study authors said that other studies have suggested people who had weight-loss surgery before hip replacements suffered fewer complications. They concluded that if people are significantly overweight, perhaps weight-loss surgery first is appropriate for a group who might be at higher risk of infection.

We asked Dr. Matthew Brengman, Bariatric Surgeon at Advanced Surgical Partners of Virginia to comment on the article. He pointed out that the article highlights a couple of aspects of joint disease in the severely and morbidly obese.  “First, obese patients’ joint disease is much more common and more severe than their normal weighted peers and the risk of surgical correction of the disease is much greater in the obese population,” said Brengman.

When we asked Dr. Brengman how bariatric surgeons collaborate with joint replacement surgeons, he told us “we work in concert with our joint replacement surgeons to treat severe osteoarthritis in the morbidly obese.  The intent is two-fold:  If we can get the weight down, many patients can have such a dramatic improvement in their joint symptoms that joint replacement can be deferred for some time or even postponed indefinitely. For those whose symptoms don’t improve enough, their joint replacement surgery becomes much lower risk.”

“Our orthopedic surgeons are especially fond of the Adjustable Gastric Band”, Brengman said, “due to the low operative risk, its negligible impact on calcium metabolism, and the lack of restriction of commonly used arthritis medications.”  His team has even performed combined joint-replacement/Adjustable Gastric Band procedures.


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