Weight Loss Before Total Joint Arthroplasty Using a Remote Dietitian and a Mobile Application: A Multicenter...

Area of Science:

• Orthopedic Surgery
• Bariatric Medicine
• Digital Health

Background:

• Surgeons often recommend preoperative weight loss for obese patients undergoing total joint arthroplasty (TJA).
• Few studies have evaluated the effectiveness of specific weight loss interventions for this patient population.
• Severe obesity presents challenges for TJA success and recovery.

Purpose of the Study:

• To compare the effectiveness of a remote, digitally-supported weight loss intervention with standard care for patients with severe obesity scheduled for TJA.
• To assess weight loss, changes in body mass index (BMI), and patient-reported outcomes.

Main Methods:

• A multicenter randomized controlled trial involving 60 patients with severe obesity (BMI 40-47 kg/m²).
• Intervention group received 12 weeks of preoperative video calls with dietitians and used a mobile app.
• Control group received standard care. Outcomes measured included weight, BMI, and patient-reported scores.

Main Results:

• Intervention group showed a trend towards greater weight loss (-4.1 kg) and BMI reduction (-1.4 kg/m²) compared to controls (-2.1 kg and -0.9 kg/m²), though not statistically significant.
• No significant differences were observed in patient-reported outcome scores (e.g., WOMAC, LEAS).
• The intervention was feasible and positively received by patients, with 83% finding video calls helpful.

Conclusions:

• Preoperative weight loss intervention using remote dietitians and a mobile app is feasible and well-tolerated.
• This approach may help address access barriers to obesity treatment prior to TJA.
• While trends favored the intervention, more intensive strategies might be necessary to achieve clinically significant weight loss for improved TJA outcomes.