Impact of Bariatric Surgery on Long Term Outcomes of Patients Undergoing Joint Arthroplasty: A Meta-Analysis.

BACKGROUND

Bariatric surgery is increasingly performed in obese patients, and its potential impact on subsequent joint arthroplasty outcomes remains unclear. Understanding this relationship is essential, as obesity significantly influences joint health and surgical success. This meta-analysis aims to assess the influence of bariatric surgery on various long-term outcomes following joint arthroplasty, specifically examining whether bariatric surgery affects the risk of complications post-surgery.

METHODS

A systematic search was conducted across Scopus, EMBASE, PubMed, Chinese National Knowledge Infrastructure, WangFeng databases, Cochrane Library, and Google Scholar. Nineteen studies were included, and data were pooled using a random-effects inverse-variance model with a DerSimonian-Laird estimate of tau. Subgroup analyses were performed for total knee arthroplasty, total hip arthroplasty, and either procedure.

RESULTS

Prior bariatric surgery showed no significant effect on the overall risk of periprosthetic infections (OR 1.018, 95% CI: 0.694 to 1.493), fractures (OR 1.052, 95% CI: 0.880 to 1.259), or revision rates (OR 1.169, 95% CI: 0.903 to 1.514). However, an increased risk of dislocation was observed in the total hip arthroplasty subgroup (OR 1.918, 95% CI: 1.036 to 3.552). High heterogeneity was noted across several outcomes.

CONCLUSIONS

Bariatric surgery does not significantly impact most long-term joint arthroplasty outcomes, although it may increase the risk of dislocation in total hip arthroplasty patients. These findings underscore the importance of considering a patient's surgical history in preoperative evaluations for joint arthroplasty, particularly in the context of obesity management and its implications for surgical outcomes.