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· DOS Abstracts
Feasibility and safety of intensive weight loss
before total knee replacement in obese patients:
A randomized controlled trial
Anette Liljensøe, Jens Ole Laursen, Henning Bliddal, Kjeld Søballe, Inger
Mechlenburg
Department of Orthopedics, Aarhus University Hospital; The Parker Institute,
Department of Rheumatology, Copenhagen University Hospital, Bispebjerg-
Frederiksberg
Background:
Annually 8500 total knee replacements (TKR) are performed
in Denmark. About 80% of this population is overweight or obese. The pres-
ent material is part of a longitudinal randomized study. ClinicalTrial.gov:
NCT01469403
Purpose / Aim of Study:
To investigate whether it is feasible and safe to im-
plement an intensive weight loss program in order to reduce preoperative body
weight of obese patients before total knee replacement (TKR) surgery.
Materials and Methods:
We conducted a pragmatic, single- blind, single-
center randomized study. Eligible patients were scheduled for TKR due to os-
teoarthritis (OA) of the knee and obesity (BMI > 30kg/m2). Participants were
randomized to either a control group that followed the standard care or a weight
loss group that followed a low-energy diet (810 kcal/day) 8 weeks before TKR.
Outcomes were assessed before intervention for the weight loss group, and
within 1 week preoperatively for both the weight loss group and the control
group.
Findings / Results:
Included were 77 patients (weight loss group n=38; con-
trol group n=39), 71% were females, the mean age was 65 years (range 46-
85), and the average BMI was 31. The average weight loss after 8 weeks was
10.7 kg. According to dual energy X-ray absorptiometry (DXA), the weight loss
consisted of a 6.7 kg reduction in fat mass, a 3.0 kg reduction in lean body mass,
and lean body mass increased by 2.3%. The intensive diets had few and mild
adverse effects. Serious cardiac complications were found in two cases in the
intervention group and in one case in the control group. All three patients later
underwent TKR without complications. No perioperative complications were re-
corded in any group.
Conclusions:
Our results show that it is feasible and safe to implement a weight
loss program shortly before TKR.
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