Department of Orthopedic Surgery, Örebro University Hospital, Örebro, Sweden.
Faculty of Medicine and Health, School of Medical Sciences, Örebro University, 702 81, Örebro, Sweden.
BMC Surg. 2023 Mar 10;23(1):53. doi: 10.1186/s12893-023-01951-6.
Patients with obesity have a higher risk of complications after total knee arthroplasty (TKA). We investigated the change in weight 1 and 2 years post-Bariatric Surgery (BS) in patients that had undergone both TKA and BS as well as the risk of revision after TKA based on if BS was performed before or after the TKA.
Patients who had undergone BS within 2 years before or after TKA were identified from the Scandinavian Obesity Surgery Register (SOReg) and the Swedish Knee Arthroplasty Register (SKAR) between 2007 and 2019 and 2009 and 2020, respectively. The cohort was divided into two groups; patients who underwent TKA before BS (TKA-BS) and patients who underwent BS before TKA (BS-TKA). Multilinear regression analysis and a Cox proportional hazards model were used to analyze weight change after BS and the risk of revision after TKA.
Of the 584 patients included in the study, 119 patients underwent TKA before BS and 465 underwent BS before TKA. No association was detected between the sequence of surgery and total weight loss 1 and 2 years post-BS, - 0.1 (95% confidence interval (CI), - 1.7 to 1.5) and - 1.2 (95% CI, - 5.2 to 2.9), or the risk of revision after TKA [hazard ratio 1.54 (95% CI 0.5-4.5)].
The sequence of surgery in patients undergoing both BS and TKA does not appear to be associated with weight loss after BS or the risk of revision after TKA.
肥胖患者在接受全膝关节置换术（TKA）后发生并发症的风险较高。我们研究了在同时接受 TKA 和减重手术（BS）的患者中，BS 后 1 年和 2 年体重的变化，以及根据 BS 是否在 TKA 之前或之后进行，TKA 后翻修的风险。
在 2007 年至 2019 年和 2009 年至 2020 年期间，分别从斯堪的纳维亚肥胖手术登记处（SOReg）和瑞典膝关节置换登记处（SKAR）中确定了在 TKA 前 2 年内或之后接受 BS 的患者，并对这些患者进行了研究。该队列分为两组：接受 TKA 在前的 BS 患者（TKA-BS）和接受 BS 在前的 TKA 患者（BS-TKA）。使用多元线性回归分析和 Cox 比例风险模型分析 BS 后体重变化和 TKA 后翻修风险。
在纳入的 584 名患者中，有 119 名患者先接受 TKA，465 名患者先接受 BS。手术顺序与 BS 后 1 年和 2 年的总减重量之间没有关联，分别为 -0.1（95%置信区间[CI]，-1.7 至 1.5）和 -1.2（95%CI，-5.2 至 2.9），也与 TKA 后翻修的风险无关[风险比 1.54（95%CI 0.5-4.5)]。
同时接受 BS 和 TKA 的患者手术顺序似乎与 BS 后体重减轻或 TKA 后翻修风险无关。
