Total weight loss associated with increased physical activity after bariatric surgery may increase the need for total joint arthroplasty

Background: Retrospectively, our institution noticed an increased number of patients undergoing total joint arthroplasty (TJA) after bariatric surgery. Considering that bariatric surgery is a proven modality to reduce osteoarthritic pain, we sought to identify a reason some patients may later require TJA. The objective of this study was to investigate the hypothesis that rapid or increased weight loss after bariatric surgery may be a risk factor for TJA. Methods: Weight loss parameters were retrospectively assessed in 15 bariatric surgery patients who subsequently received a primary TJA and compared with matched bariatric controls. Results: Patients who required a TJA lost 27.9% more of their body mass index (BMI) compared with controls (P = .049). Furthermore, patients who underwent TJA 25-48 months postbariatric surgery lost 78.2% more of their BMI compared with controls (P < .001). Total knee arthroplasty patients lost 43.9% more of their BMI compared with controls (P = .02), and the difference in BMI change for total hip arthroplasty patients was not significant versus controls. Conclusion: These results contradict the tenant that weight loss is universally protective against arthritis and merit larger prospective investigations. (Surg Obes Relat Dis 2014;10:335-339.) (C) 2014 American Society for Metabolic and Bariatric Surgery. All rights reserved.