Osteoarthritis in hips and knees is a common progressive disease leading to joint pain and severe disability. It is a complex multifactorial condition leading to damage of cartilage, deposition of subchondral bone matrix and release of pro-inflammatory cytokines.
One of the most common risk factors for osteoarthritis is carrying around excess weight. In fact, no matter what the root cause of the problem (trauma or otherwise), weight loss has consistently been shown to reduce pain (for e.g. each lb lost takes about four pounds off each knee).
So the question arises, whether bariatric surgery should be used more commonly in obese patients with osteoarthritis in hips or knees.
In a paper authored by Richdeep Gill and other colleagues, just published in Obesity Reviews, we report our findings from a systematic review of the literature on bariatric surgery and osteorarthritis.
A comprehensive search of electronic databases using broad search terms revealed a total of 400 articles, including six studies, which met our criteria for inclusion in our qualitative analysis.
Although there was a clear trend towards improvement of hip and knee osteoarthritis in hips and knees following bariatric surgery, the data consists largely of case series.
Thus, it may well be time to conduct a large randomized controlled trial to determine whether or not bariatric surgery should perhaps be routinely considered as a means to better manage hip or knee osteoarthritis in patients with severe obesity.
Gill RS, Al-Adra DP, Shi X, Sharma AM, Birch DW, & Karmali S (2011). The benefits of bariatric surgery in obese patients with hip and knee osteoarthritis: a systematic review. Obesity reviews : an official journal of the International Association for the Study of Obesity PMID: 21883871