Rishi Lajja, Bhandari Mohit, Kumar Ravindra
Department of Physiotherapy, Sri Aurobindo Medical College and PG Institute, Mohak Bariatrics and Robitics, Indore, Madhya Pradesh, India.
Central Research Laboratory, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, India.
J Minim Access Surg. 2018 Jan-Mar;14(1):13-17. doi: 10.4103/jmas.JMAS_129_16.
The objective of the study was to find the weight reduction pattern and its outcome on knee pain and function in osteoarthritis (OA) morbidly obese patients' post-bariatric surgery with dietary and exercise changes.
Thirty morbidly obese (body mass index [BMI] >40 kg/m2) OA patients gave consent for bariatric surgery. Despite wearisome lifestyle modifications for weight loss and knee pain, satisfactory results were not retrieved. We took consent from all the patients predetermined for knee replacement in future because of pain and disability as recommended by knee replacement surgeon. The dietary and exercise protocol was standardised for all patients for bariatrics. Data for weight loss, change in BMI and Western Ontario and McMaster Universities Arthritis Index score consisting of pain, stiffness and activities of daily livings (ADLs) scores were documented at baseline, 3 months and 6 months post-bariatric surgery.
The male-to-female ratio was 1:2. Mean age of the patients was 49.8 ± 8.6 years. Significant changes in pain (P < 0.001), stiffness (P < 0.001) and ADLs (P < 0.001) were found postoperatively at 3 and 6 months. Positive correlation of percentage change of BMI was seen with percentage change in pain (r = 0.479, P = 0.007) and ADLs (r = 0.414, P = 0.023) after 6 months of bariatric surgery. Most of the patients were inclined to delay the knee replacement further by the end of 6 months post-bariatric surgery.
Bariatric surgery when combined with dietary and exercise changes gave significant results in terms of weight loss, knee pain and function. It is an approach that tackles both obesity and OA. It is a major step forward in stemming the global epidemic of these two interlinked conditions.
本研究的目的是探寻病态肥胖的骨关节炎（OA）患者在接受减肥手术后，通过饮食和运动改变所呈现的体重减轻模式及其对膝关节疼痛和功能的影响。
30名病态肥胖（体重指数[BMI]>40kg/m²）的OA患者同意接受减肥手术。尽管为了减肥和缓解膝关节疼痛进行了令人厌烦的生活方式改变，但仍未取得满意效果。按照膝关节置换外科医生的建议，我们征得所有因疼痛和残疾而预定未来进行膝关节置换的患者的同意。对所有减肥患者的饮食和运动方案进行了标准化。记录了减肥手术后基线、3个月和6个月时的体重减轻数据、BMI变化以及由疼痛、僵硬和日常生活活动（ADL）评分组成的西安大略和麦克马斯特大学关节炎指数评分。
男女比例为1:2。患者的平均年龄为49.8±8.6岁。术后3个月和6个月时，疼痛（P<0.001）、僵硬（P<0.001）和ADL（P<0.001）出现了显著变化。减肥手术6个月后，BMI变化百分比与疼痛变化百分比（r = 0.479，P = 0.007）和ADL变化百分比（r = 0.414，P = 0.023）呈正相关。大多数患者倾向于在减肥手术后6个月末进一步推迟膝关节置换。
减肥手术与饮食和运动改变相结合，在体重减轻、膝关节疼痛和功能方面取得了显著效果。这是一种同时解决肥胖和OA问题的方法。这是在遏制这两种相互关联疾病的全球流行方面向前迈出的重要一步。
