DOS 2016

DOS Kongressen 2016 ·

Weight Loss Intervention before Total Knee

Replacement

Anette Liljensøe, Jens Ole Laursen, Henning Bliddal, Kjeld Søballe, Inger

Mechlenburg

Department of Ortopaedics, Aarhus University Hospital; Emergency Medicine,

University of Southern Denmark; Department of Rheumatology, Copenhagen

University Hospital Bispebjerg Frederiksberg; Department of Ortopaedics,

Aarhus University Hospital; Department of Ortopaedics, Aarhus University

Hospital

Background:

Obesity increasingly leads to problems in patients after Total knee

replacement (TKR). Several observational studies have shown that obesity is

associated with poor health- related quality of life (QoL), physical function, and

more pain after surgery than in patients with BMI < 30.

Purpose / Aim of Study:

To investigate whether weight loss interventions

before primary TKR would improve QoL, knee function, mobility, and body com-

position 1 year after surgery.

Materials and Methods:

Patients scheduled for TKR due to osteoarthritis (OA)

of the knee and obesity were randomized to a control group with standard care

or to an 8-week low-energy 810kcal/d liquid diet before TKR. Patient-reported

QoL, 6 Minutes’ Walk Test (6MW), and body composition by dual energy X-ray

absorptiometry (DXA) were assessed before intervention for the diet group,

and within 1 week preoperatively for both groups, and the change in outcome

from baseline to 1 year after TKR were compared between groups.

Findings / Results:

The results showed large improvement in both study groups

in QoL and knee function, with no statistical differences between the groups 1

year after TKR. The average weight loss after 8-week preoperatively interven-

tion was 10.7 kg, and consisted of a 6.7 kg reduction in fat mass. 20% more

subjects mobilized immediately after surgery in the diet group than in the con-

trol group. 1 year after TKR the participants in the diet group managed to main-

tain the weight reduction, whereas there was no change in the control group.

Conclusions:

An 8-week pre-operative intervention resulted in a 10% body

weight loss, improved body composition, cardiovascular risk factors and s-leptin

sustained after TKA surgery for one year. One year after surgery the weight loss

group did not achieve a greater improvement in QoL and knee function than the

control usual care group.

No conflicts of interest reported

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