Weight loss before total joint arthroplasty using a remote dietitian and mobile app: study protocol for a multicenter...

Area of Science:

• Orthopaedic Surgery
• Obesity Medicine
• Digital Health

Background:

• Severe obesity (BMI > 40 kg/m² ) presents challenges for elective surgery, including total joint arthroplasty (TJA).
• Pre-operative weight loss can optimize surgical outcomes and patient eligibility for TJA.
• Upcoming TJA can motivate patients with severe obesity to pursue lifestyle changes.

Purpose of the Study:

• To assess the feasibility and efficacy of a remote, dietitian-supervised weight loss intervention for patients with severe obesity awaiting TJA.
• To evaluate a 12-week program combining dietary and physical activity guidance via a mobile app and remote dietitian support.
• To determine if the intervention helps patients achieve a BMI below 40 kg/m² and lose at least 20 pounds.

Main Methods:

• A multicenter randomized controlled trial involving 60 patients with severe obesity scheduled for TJA.
• Intervention group received a 12-week program with a mobile app and weekly/bi-weekly remote dietitian consultations.
• Control group received standard clinical care. Data collected via surveys, interviews, app usage, and medical records.

Main Results:

• Primary outcome: weight change from baseline.
• Secondary outcomes: TJA eligibility, dietitian session completion, global health status, joint pain/function, and serological markers (e.g., HbA1c, albumin).
• Qualitative data from interviews will explore patient experiences with the intervention.

Conclusions:

• This study is the first to evaluate a pre-operative weight loss intervention using a registered dietitian and mobile app for patients with severe obesity undergoing orthopaedic surgery.
• The findings will inform the development of effective remote interventions to improve surgical readiness and outcomes in this population.