Joint problems go down, hip and knee replacements go up after Bariatric surgery
SAN FRANCISCO, June 30, 2006 – People with morbid obesity who have bariatric surgery significantly reduce their hip, knee and back problems and after significant weight loss, are more likely to have needed back surgery and hip and knee replacements, according to a new study.
31-12-2006
 Researchers from Canada presented their findings today at the 23rd Annual Meeting of the American Society for Bariatric Surgery (ASBS). They compared 1,035 patients who had bariatric surgery to 5,746 patients who had morbid obesity but did not undergo surgery from 1986 to 2002.
“Bariatric surgery reduces or prevents further joint problems, but it cannot undo the damage that has already been done due to the pressure on the joints and back from excess weight,” said Nicolas V. Christou, MD, PhD, lead author from McGill University Health Center in Montreal, Quebec. “Bariatric surgery though can make back surgery or hip and knee replacement possible for people who otherwise would have to suffer in pain and have reduced mobility.”
Bariatric surgery patients reduced their need for knee arthroscopy, a minimally invasive surgical procedure to evaluate damaged cartilage, by nearly half (5.17% or 53/1035 patients) compared to those who did not have surgery (9.05% or 520/5,746 patients). Medical treatment for arthritis among the bariatric surgery group was 11.6% (120) compared to 15.7% (906) in the non-surgery group. On average, bariatric surgery patients lost 67.1% of their excess body weight. Patients were followed up to five years.
The bariatric surgery group had more hip replacements, 5.3% (55) and knee replacements, 13.4% (139) compared to the non-surgery group, 4.81% (276) and 10.4%, respectively. The amount of back surgeries also increased in the bariatric group, 8.83% (91) compared to the non-surgery group, 6.36% (366).
As with any surgery, the risks and benefits should be carefully considered by the surgeon, the patient and the patient’s family. According to the ASBS, the average mortality rate in an ASBS Center of Excellence is 0.3 percent after 90 days based on an analysis of 33,000 patients. A 2004 study published in the Journal of the American Medical Association (JAMA)* showed 0.1% mortality for laparoscopic adjustable gastric band (LAGB) patients, 0.5% mortality for gastric bypass patients and 1% mortality for biliopancreatic diversion (BPD) and duodenal switch (DS) patients.
In 2005, the ASBS reported that an estimated 170,000 people in the U.S. had bariatric surgery. About 15 million or 1 in 50, adults in the U.S. have morbid obesity, which is associated with numerous other diseases and conditions including Type 2 diabetes, heart disease, sleep apnea, hypertension, asthma, cancer joint problems and infertility. The direct and indirect costs to the healthcare system associated with obesity are about $117 billion annually.
The ASBS is the largest organization for bariatric surgeons in the world. It is a non-profit organization that works to advance the art and science of bariatric surgery and is committed to educating medical professionals and the lay public about bariatric surgery as an option for the treatment of morbid obesity, as well as the associated risks and benefits. It encourages its members to investigate and discover new advances in bariatric surgery, while maintaining a steady exchange of experiences and ideas that may lead to improved surgical outcomes for morbidly obese patients. For more information about the ASBS visit www.asbs.org.
* Buchwald H, Avidor Y, Braunwald E, Jensen M, Pories W, Fahrbach K, Schoelles, Bariatric surgery: A systematic review and meta-analysis. JAMA, 2004,292:1724-57.Source: www.asbs.org.
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