Feng Yuan, Ju Hongqing, Chen Lili, Zhou Yan
Qingdao Traditional Chinese Medicine Hospital, Qingdao Hiser Hospital Affiliated of Qingdao University, Qingdao, China.
Obes Surg. 2025 May 30. doi: 10.1007/s11695-025-07953-y.
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.
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.
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.
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.
肥胖症手术在肥胖患者中越来越普遍，但其对后续关节置换手术结果的潜在影响仍不明确。鉴于肥胖对关节健康和手术成功有重大影响，了解这种关系至关重要。本荟萃分析旨在评估肥胖症手术对关节置换术后各种长期结果的影响，特别研究肥胖症手术是否会影响术后并发症风险。
在Scopus、EMBASE、PubMed、中国知网、万方数据库、Cochrane图书馆和谷歌学术上进行了系统检索。纳入了19项研究，并使用随机效应逆方差模型和DerSimonian-Laird估计的tau值进行数据合并。对全膝关节置换术、全髋关节置换术以及任何一种手术进行了亚组分析。
既往肥胖症手术对假体周围感染的总体风险（比值比1.018，95%置信区间：0.694至1.493）、骨折（比值比1.052，95%置信区间：0.880至1.259）或翻修率（比值比1.169，95%置信区间：0.903至1.514）无显著影响。然而，在全髋关节置换术亚组中观察到脱位风险增加（比值比1.918，95%置信区间：1.036至3.552）。在几个结果中发现了高度异质性。
肥胖症手术对大多数长期关节置换手术结果没有显著影响，尽管它可能会增加全髋关节置换术患者的脱位风险。这些发现强调了在关节置换术前评估中考虑患者手术史的重要性，特别是在肥胖管理及其对手术结果的影响方面。
