A study in Journal of Bone and Joint Surgery suggests benefits of bariatric surgery in morbidly obese patients with end-stage osteoarthritis prior to undergoing a total knee replacement (TKR) procedure.

In the study, researchers used a computer model to analyze previously published data on obesity, bariatric surgery, and TKR. The evaluation compared the costs and outcomes of two treatment options for patients with morbid obesity (a BMI greater than 35 kg/m2) and end-stage knee osteoarthritis: The first, TKR without prior weight loss; and the second, TKR 2 years after bariatric surgery, a media release from the American Academy of Orthopedic Surgeons explains.

The model predicts that patients with morbid obesity who undergo bariatric surgery 2 years prior to TKR are more likely to enjoy improved quality of life, measured in quality-adjusted life years (QALYs), than patients undergoing TKR without prior weight loss surgery. In addition, the cost necessary for this level of improvement was $13,910 per QALY, which is below the amount society and healthcare payors, like insurers and the government, are typically willing to pay, the release continues.

“We found that successful bariatric surgery performed 2 years before TKR could be a cost-effective treatment strategy for morbidly obese patients with end-stage arthritis,” says orthopaedic surgeon and lead article author Alexander McLawhorn, MD, MBA, in the release.

“While there remains some uncertainty in terms of the precise effects of bariatric surgery on knee osteoarthritis and total knee replacement, our model summarizes what is known about the clinical effects and costs of obesity, bariatric surgery, and total knee replacement,” he adds.

McLawhorn notes in the release that the study results may help surgeons in counseling morbidly obese patients with knee osteoarthritis, and trying to come up with an individualized treatment plan that includes optimization of overall health, nutrition, and weight prior to knee replacement.

[Source(s): American Academy of Orthopedic Surgeons, EurekAlert]