Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California.
Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland.
J Arthroplasty. 2024 Jan;39(1):38-43. doi: 10.1016/j.arth.2023.07.017. Epub 2023 Jul 31.
The obesity epidemic in the United States continues to grow with more than 40% of individuals now classified as obese (body mass index >30). Obesity has been readily demonstrated to increase the risk of developing hip and knee osteoarthritis and is known to increase the risk of complications following joint arthroplasty. Weight loss prior to arthroplasty may mitigate this risk of complications; however, the existing evidence remains mixed with no clear consensus on the optimal method of weight loss and timing prior to arthroplasty. Treatment options for weight loss have included nonsurgical lifestyle modifications consisting of structured diet, physical activity, and behavioral modification, as well as bariatric and metabolic surgery (ie, sleeve gastrectomy, Roux-en-Y gastric bypass, and the adjustable gastric band). Recently, glucagon-like peptide-1 receptor agonists have gained notable popularity within the scientific literature and media for their efficacy in weight loss. The aim of this review is to provide a foundational primer for joint arthroplasty surgeons regarding the current and emerging options for weight loss to aid surgeons in shared decision-making with patients prior to arthroplasty.
美国的肥胖症流行仍在持续增长，目前超过 40%的人被归类为肥胖（身体质量指数>30）。肥胖症已被证实会增加髋关节和膝关节骨关节炎的发病风险，并且已知会增加关节置换术后并发症的风险。关节置换术前减轻体重可能会降低这种并发症的风险；然而，现有证据仍然存在争议，没有关于关节置换术前减肥的最佳方法和时间的明确共识。减肥的治疗选择包括非手术生活方式改变，包括结构化饮食、身体活动和行为改变，以及减重和代谢手术（即袖状胃切除术、胃旁路术和可调胃束带）。最近，胰高血糖素样肽-1 受体激动剂因其在减肥方面的疗效而在科学文献和媒体中引起了广泛关注。本文旨在为关节置换外科医生提供有关减肥的当前和新兴选择的基础知识，以帮助外科医生在关节置换术前与患者进行共同决策。
