A study from the Hospital for Special Surgery in New York City suggests that bariatric surgery prior to total knee replacement (TKR) may be a cost-effective option to improve outcomes.

A research team led by Alexander McLawhorn, MD, MBA, used a computer software program to compare the cost-effectiveness of two treatment protocols for patients who were morbidly obese (BMI of at least 35) and had advanced knee osteoarthritis. One group underwent TKR immediately, without losing weight. Another group underwent the TKR procedure 2 years after having bariatric surgery and losing weight, explains a media release from Hospital for Special Surgery.

The computer model predicted that the patients who had bariatric surgery 2 years prior to TKR were more likely to enjoy improved quality of life, measured in quality-adjusted life years (QALYs), compared to patients undergoing TKR without prior weight loss surgery. In addition, the cost necessary for this level of improvement was $13,910 per QALY, which is below the amount society and healthcare payors, such as insurance companies and the government, are typically willing to pay, the release continues.

“The computer model supports bariatric surgery prior to total knee replacement as a cost-effective option for improving outcomes in morbidly obese patients with end-stage knee osteoarthritis,” McLawhorn states in the release.

He notes, however, that for some patients experiencing severe knee pain, it may not be wise to have the patient hold off on undergoing the TKR procedure. Another important consideration, according to McLawhorn, is the nutritional assessment for patients scheduled to undergo orthopedic surgery, especially those who have had bariatric surgery, per the release.

“Ideally, a team approach should be used to treat severely obese patients with knee arthritis in which various health care professionals are in place to help a patient lose weight, improve his or her health, and optimize nutrition before joint replacement to maximize its benefits,” he says.

The study was published recently in The Journal of Bone & Joint Surgery.

[Source(s): Hospital for Special Surgery, Newswise]