Department of Medical Education, Advanced Gastrointestinal Minimally Invasive Surgery and Bariatric Fellowship, Gundersen Health System, 1900 South Avenue C05-001, La Crosse, WI 54601, USA.
Department of Surgery, Gundersen Health System, 1900 South Avenue C05-001, La Crosse, WI 54601, USA.
Surg Clin North Am. 2021 Apr;101(2):295-305. doi: 10.1016/j.suc.2020.12.011.
Obesity is an independent risk factor for osteoarthritis due to mechanical and inflammatory factors. The gold-standard treatment of end-stage knee and hip osteoarthritis is total joint arthroplasty (TJA). Weight loss decreases progression of osteoarthritis and complications following TJA in patients with obesity. Bariatric surgery allows significant, sustained weight loss and comorbidity resolution in patients with morbid obesity. Existing data describing bariatric surgery on TJA outcomes are limited but suggest a benefit to bariatric surgery prior to TJA. Further studies are needed to determine optimal risk stratification, bariatric procedure selection, and timing of bariatric surgery relative to TJA.
肥胖是骨关节炎的一个独立危险因素，其与机械和炎症因素有关。终末期膝和髋关节骨关节炎的金标准治疗方法是全关节置换术（TJA）。对于肥胖患者，减肥可以减缓骨关节炎的进展并降低 TJA 后的并发症发生率。减重手术可使病态肥胖患者显著、持续地减轻体重并解决合并症。目前关于减重手术对 TJA 结果的描述数据有限，但表明在 TJA 之前进行减重手术有益。需要进一步的研究来确定最佳的风险分层、减重手术程序选择以及相对于 TJA 的减重手术时机。
