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Drug Dosing: Obese Patients01:21

Drug Dosing: Obese Patients

182
In the United States, obesity is a prominent concern. It is linked to heightened mortality rates due to increased occurrences of conditions such as hypertension, atherosclerosis, coronary artery disease, and diabetes compared to nonobese individuals. A patient is classified as obese if their actual body weight surpasses the ideal or desirable body weight by 20%, based on Metropolitan Life Insurance Company data. Ideal body weights consider average weights and heights for males and females...
182

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Multidisciplinary Approach to Obesity Management: A Case Report
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Weight Loss Intervention Before Total Knee Replacement: A 12-Month Randomized Controlled Trial.

A Liljensøe1, J O Laursen2, H Bliddal3

  • 1Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark.

Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society
|November 5, 2019
PubMed
Summary

A pre-surgery weight loss diet for obese patients undergoing total knee replacement is safe and feasible. While not statistically significant, the intervention group maintained weight loss and improved body composition one year post-surgery.

Keywords:
Obesityjoint replacementknee osteoarthritisleptinquality of lifeweight loss

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Area of Science:

  • Orthopedics
  • Obesity Medicine
  • Metabolic Health

Background:

  • Obesity is a growing concern for patients undergoing total knee replacement (TKR).
  • Excess weight can negatively impact surgical outcomes and patient recovery.

Purpose of the Study:

  • To evaluate the impact of a pre-operative weight loss intervention on quality of life, knee function, mobility, and body composition one year after primary TKR.
  • To assess the feasibility and safety of an intensive low-energy diet prior to TKR in obese patients.

Main Methods:

  • Randomized controlled trial comparing a standard care group with an 8-week low-energy diet intervention group before TKR.
  • Outcomes including patient-reported quality of life, 6-Minute Walk Test, and body composition (DXA) were assessed pre-intervention and one year post-surgery.
  • A reduced sample size may have limited statistical power to detect significant differences.

Main Results:

  • Both groups showed significant improvements in quality of life and knee function one year after TKR.
  • The intervention group achieved an average weight loss of 10.7 kg (6.7 kg fat mass) during the 8-week pre-operative diet.
  • Weight loss was maintained in the diet group at one year, while the control group showed no change.

Conclusions:

  • An intensive pre-operative weight loss program is feasible and safe for obese patients scheduled for TKR.
  • The intervention led to substantial weight loss, improved body composition, and reduced cardiovascular risk factors.
  • Sustained weight reduction and improved metabolic markers suggest potential long-term benefits.