Associations Between Weight Loss Prior to Knee and Hip Arthroplasty and Peri‐ and Post‐Operative Outcomes: A Systematic Review and Meta‐Analysis

BACKGROUND: In some of the existing literature, obesity is associated with increased complications in those who undergo lower limb arthroplasty. We conducted a systematic review and meta-analysis to assess if pre-arthroplasty weight loss mitigates increased post-operative risks. METHODS: who underwent pre-arthroplasty weight loss) and a control group (patients who underwent arthroplasty without preceding weight loss) 90 days post-arthroplasty were selected and data were extracted from studies meeting these inclusion criteria. Data were analyzed using a random effects model. FINDINGS: Twenty-one articles were included in the meta-analysis. In people with obesity, pre-arthroplasty weight loss was associated with an increased risk of revision surgery in the first 90 days following lower limb arthroplasty (OR 1.37 [1.01-1.84], p = 0.04). Weight loss did not alter the risk of post-operative DVT, PE, superficial wound infections, and deep wound infections. CONCLUSIONS: Our results demonstrate that pre-arthroplasty weight loss does not improve short-term post-operative outcomes in people with obesity. Large, well-designed prospective studies should be performed to provide robust data for the development of evidence-based guidelines for lower limb arthroplasty in people living with obesity.