Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
Obes Rev. 2011 Dec;12(12):1083-9. doi: 10.1111/j.1467-789X.2011.00926.x. Epub 2011 Aug 25.
Osteoarthritis is a common progressive disease leading to joint pain and severe disability. It is a complex multifactorial disease leading to damage of cartilage, deposition of subchondral bone matrix and release of pro-inflammatory cytokines. Obesity is an emerging epidemic and also an important risk factor for osteoarthritis. Weight loss has been shown to improve pain and function in hip and knee joints with osteoarthritis. Bariatric surgery currently is the only evidence-based approach to marked weight loss in obese individuals. However, there is currently limited literature to evaluate the role of bariatric surgery in hip and knee osteoarthritis. The objective of the present study was to systematically review the literature regarding the effectiveness of bariatric surgery in obese adult patients in improving large weight-bearing joint (hip and knee) osteoarthritis. Published English-language manuscripts were considered for review inclusion. A comprehensive search of electronic databases using broad search terms was completed. From a total of 400 articles, eight articles were identified. A total of six studies were included for qualitative analysis. A general trend was identified indicating improved hip and knee osteoarthritis following marked weight loss secondary to bariatric surgery. This systematic review demonstrates that bariatric surgery may benefit obese patients with hip or knee osteoarthritis. However, this review identifies the need for randomized controlled trials to clarify the role and indications for bariatric surgery.
骨关节炎是一种常见的进行性疾病，可导致关节疼痛和严重残疾。它是一种复杂的多因素疾病，可导致软骨损伤、软骨下骨基质沉积和促炎细胞因子的释放。肥胖是一种新出现的流行疾病，也是骨关节炎的一个重要危险因素。体重减轻已被证明可改善髋膝关节骨关节炎的疼痛和功能。减肥手术目前是肥胖个体显著减肥的唯一循证方法。然而，目前关于减肥手术在髋膝关节骨关节炎中作用的文献有限。本研究的目的是系统地回顾关于减肥手术对肥胖成年患者改善大负重关节（髋和膝关节）骨关节炎的疗效的文献。纳入了发表的英文文献。使用广泛的搜索词完成了电子数据库的全面搜索。在总共 400 篇文章中，确定了 8 篇文章。共有 6 项研究进行了定性分析。研究结果表明，减肥手术后的显著体重减轻可改善髋膝关节骨关节炎，这是一个普遍趋势。这项系统评价表明，减肥手术可能有益于髋或膝关节骨关节炎的肥胖患者。然而，本研究确定需要进行随机对照试验来阐明减肥手术的作用和适应证。
