Weight changes following total hip and total knee arthroplasty - A systematic review.

Abstract

The background and purpose of the study: Symptomatic osteoarthritis can result in reduced mobility and exercise tolerance, leading to weight gain. Patients often feel that arthroplasty will result in improved mobility, reduced pain, and subsequent weight loss. The purpose of this systematic review was to assess weight changes following lower limb arthroplasty from available published literature.

Methods: A systematic review of PubMed, EMBASE and Cochrane Library databases were performed in accordance to PRISMA guidelines. Studies reporting significant weight changes of 5 % of pre-operative weight, 5 % of BMI and total weight change in kilograms following hip and knee arthroplasty were included. Outcomes assessed were weight changes according to groupings 'weight gain', 'maintained weight' and 'weight loss'. Secondarily we assessed weight changes in kilograms. Methodological quality of evidence was assessed using MINORS criteria.

Results: In total, 21 studies were included with a total of 55,245 patients. In the '5 % of total weight' group 12.5 % gained weight, 74.2 % maintained weight and 13.3 % lost weight (weighted means). In the '5 % of BMI' group 22.1 % gained weight, 66.3 % maintained weight and 13.9 % lost weight (weighted means). Overall, 13 studies reported a weighted mean weight change of +0.7 kg. The majority of studies were of moderate/poor quality using MINORS criteria.

Conclusions: This systematic review found that the majority of patients maintain their preoperative weight following hip and knee arthroplasty. This study suggests that arthroplasty does not lead to weight loss from improved pain and mobility in the majority of patients. This study presents data that is important for surgeons and patients alike when considering potential weight changes following arthroplasty.