肥満外科手術が変形性関節症関連の疼痛および機能に及ぼす影響：系統的レビューおよびメタアナリシス

This systematic review and meta-analysis aimed to synthesize current evidence on the effect of metabolic and bariatric surgery on osteoarthritis (OA) diagnosis, pain, stiffness, and functional outcomes.

A systematic search was conducted in PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library for studies published between January 2000 and July 2025. Eligible studies included adult patients undergoing any form of bariatric surgery who had either a documented diagnosis of OA before and after surgery or a quantitative assessment of OA-related symptoms using validated instruments such as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Data were pooled using random-effects models, and heterogeneity was assessed using the I² statistic.

Twelve studies published between 2007 and 2024 met the inclusion criteria, encompassing 12,000 participants across prospective and retrospective cohorts. The pooled odds ratio for OA diagnosis after surgery compared with preoperative status was 0.21 (95% CI: 0.11-0.41), indicating a 79% reduction in OA likelihood. Significant improvements were observed in WOMAC pain, stiffness, and physical function scores at 6 and 12 months postoperatively, with overall pooled mean differences of -20.80 (95% CI: -32.74 to -8.86) and -17.12 (95% CI: -25.28 to -8.96), respectively. Heterogeneity was substantial across studies (I² > 75%).

Metabolic and bariatric surgery is associated with significant reductions in osteoarthritis diagnosis and improvements in OA-related pain and physical function. These findings suggest that surgical weight loss may provide meaningful benefits for joint health in patients with obesity.