Bariatric surgery before joint replacement can improve outcomes in obese

Two studies at Hospital for Special Surgery in New York City find bariatric surgery prior to joint replacement is a cost-effective way to improve outcomes after hip or knee replacement, as obesity is linked to longer hospital stays, higher failure rates and costly surgery.

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Investigators used software to compare cost-utility of two treatment protocols for morbidly obese patients who also had advanced knee or hip osteoarthritis. One group had bariatric surgery before a hip or knee replacement two years later, the other group had the procedure done without losing weight.

“Our findings indicate that surgical weight loss prior to joint replacement is likely a cost-effective option from a public payer standpoint in order to improve outcomes in obese patients who are candidates for joint replacement,” said Emily Dodwell, MD, an orthopedic surgeon at HSS and lead investigator. “Some healthcare systems do not include weight loss surgery as a covered benefit, and it is possible that studies such as this will be helpful in re-evaluating whether weight loss surgery may be a reasonable covered benefit.”

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