Joint Pain Outcomes After Metabolic and Bariatric Surgery in Patients With and Without Hypermobility

Obesity increases the risk of musculoskeletal conditions, but retrospective studies have suggested that individuals with joint hypermobility experience more joint pain after metabolic and bariatric surgery and weight loss. Joint hypermobility is the ability of one or more joints to move beyond the normal range of motion. This study prospectively investigated postoperative joint pain and its association with joint hypermobility.

A survey including the 5-Part Questionnaire (5PQ) and a self-developed joint pain questionnaire was completed prior to and 1 year after metabolic and bariatric surgery. Participants were categorized as having hypermobility based on the 5PQ.

Seventy-four participants completed both surveys; 15 reported hypermobility postoperatively, 59 did not. The two groups were similar in age, sex, pre-operative and postoperative weight, BMI, and weight loss. In the group without hypermobility, pain frequency significantly decreased in the neck, lumbar spine, hips, knees, ankles, and feet/toes, and they reported fewer painful body parts postoperatively. The hypermobility group did not report significant changes in pain frequency or number of painful joints. However, total pain frequency was not different between the groups.

Weight loss after metabolic and bariatric surgery was associated with reduced joint pain only in patients without hypermobility. Participants with hypermobility tended to maintain pain in load-bearing joints, suggesting that joint hypermobility limits pain improvement. Targeted monitoring and muscle-strengthening interventions may benefit this population.

The trial was registered in "FoU in Sweden" (Research and Development in Sweden) on May 1, 2015 (registration number: 202221) and in Clinical Trials June 8, 2018 (NCT03641027).