Catching up on news during our months long hiatus, the June issue of Clinical Orthopaedics and Related Research featured members of OPUS and highlighted the importance of weight and mortality after total joint surgery.
Lead author, Associate Professor Michelle Dowsey, explained in the Editor’s Spotlight feature that contrary to popular line of thought, obese patients were less likely to have life-threatening complications or death following total joint surgery compared to underweight patients. Rather, it is underweight patients that may require further risk assessment post-surgery.
Using data pooled together from the St. Vincent’s Melbourne Arthroplasty Registry and Kaiser Permanente Total Joint Replacement Registry, over 150,000 patient records were analysed. Although patient selection bias may exist whereby only the healthiest of patients categorised as ‘obese’, are referred on for major surgical procedures, the study concludes that it is in fact, patients presenting as underweight, that are associated with a higher mortality risk post-surgery.
Why this happens is still unknown, but A/Prof Dowsey does offer some suggestions: nutrition and physical activity. Clinicians referring patients to joint replacement surgery should be mindful that weight management and nutrition be carefully considered: obese patients are no more at risk that those of normal BMI ranges.
It is important to note here that this particular study examines the links that extend the number of years post-surgery. The foundations of OPUS is based on improving the quality of life for sufferers of osteoarthritis, measuring the remaining life is just one facet that influences quality. This latest study is just one of several research streams currently investigated to improve the patient experience.