Related Experiment Video
Updated: Jan 21, 2026
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
The Effect of Bariatric Surgery Prior to Lower-Extremity Total Joint Arthroplasty: A Systematic Review
Alex Gu1,2, Jordan S Cohen1, Michael-Alexander Malahias2
11George Washington University School of Medicine and Health Sciences, 2300 Eye St. NW, Washington, DC 20037 USA.
Background:
Obesity is an independent risk factor for osteoarthritis and has been associated with increased rate of complications following lower-extremity total joint arthroplasty (TJA). Bariatric surgery (BS) is a surgical option for weight loss and for reducing obesity-related comorbidities in morbidly obese patients.
Purpose/Questions:
The goal of this systematic review was to answer the following questions: (1) Does BS prior to TJA correlate with lower post-operative complication rates in morbidly obese patients undergoing TJA? (2) Does BS have an impact on revision rates following TJA?
Methods:
Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and checklist, a systematic review of medical databases (PubMed/ MEDLINE, Cochrane Library, Web of Science, and Clinicaltrials.gov) was undertaken for articles published in English from January 1990 to September 2018. Inclusion criteria were studies that included at least ten patients who underwent BS prior to TJA, collected data on complications or other outcomes, and followed patients for at least 90 days after TJA. A descriptive and critical analysis of the results was performed.
Results:
From 799 studies, 13 met inclusion criteria. A total of 11,770 patients who had undergone bariatric surgery prior to TJA were analyzed. The quality of the evidence ranged between moderate and high. There was no consensus on the effect of previous BS on early- to short-term outcomes reported after TJA.
Conclusion:
The literature remains conflicted on the impact of BS prior to TJA on early, short-term, and long-term complications after TJA. Additional well-matched, observational studies may further our understanding of the impact of BS prior to TJA on outcomes. In particular the effect of various types of BS prior to TJA on outcomes has yet to be elucidated. Ideally, prospective studies with higher level of evidence will be more definitive on the effects of BS prior to TJA.Prospero Registration Number: CRD42016043025.
Related Concept Videos
01:10Review and Preview
Percentiles are a type of fractile that partition data into...
01:13Review and Preview
01:16Structural Joints: Synovial Joints
01:03Structural Joints: Fibrous Joints
Suture
All the bones of the skull, except for the mandible, are joined to each other by a fibrous joint called a suture. The fibrous connective tissue found at a suture strongly unites the adjacent skull bones and thus helps to protect the brain and form the face. In...
01:17Structural Joints: Cartilaginous Joints
There are two types of cartilaginous joints:
Synchondrosis
A synchondrosis ("joined by cartilage") is a cartilaginous joint where bones are connected by hyaline cartilage. Synchondrosis may be temporary...
01:26Joints
Structural joint classifications are based on the material that makes up the joint as well as whether or not the joint contains a space between the bones. Joints are structurally classified as fibrous, cartilaginous, or synovial.
Fibrous Joints Are Immovable
The bones of a...