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Arch Iran Med. 2025;28(8): 461-471.
doi: 10.34172/aim.34291
  Abstract View: 160
  PDF Download: 44

Systematic Review

Impact of Prior Metabolic and Bariatric Surgery on Outcomes of Total Knee and Total Hip Arthroplasty: A Systematic Review and Meta-analysis

Mahta Shari’at Moghani 1 ORCID logo, Ali Esparham 2 ORCID logo, Mohammad Mahdinezhad Kashani 3 ORCID logo, Negar Einafshar 1 ORCID logo, Mahsa Radboy 4 ORCID logo, Mohammad Javad Ghamari 5 ORCID logo, Tooraj Zandbaf 5* ORCID logo

1 Students Research Committee, MMS.C., Islamic Azad University, Mashhad, Iran
2 Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
3 Department of Orthopedic, MMS.C., Islamic Azad University, Mashhad, Iran
4 Innovative Medical Research Center, MMS.C., Islamic Azad University, Mashhad, Iran
5 Department of General Surgery, MMS.C, Islamic Azad University, Mashhad, Iran
*Corresponding Author: Tooraj Zandbaf, Email: zandbaft@iaumshms.ac.ir, Email: tooraj.zandbaf@gmail.com

Abstract

Background: The current study evaluated the effects of prior metabolic and bariatric surgery (MBS) on complications after total knee/hip arthroplasty (TKA/THA). We performed a meta-analysis to assess the impact of prior MBS on TKA/THA outcomes.

Methods: Our systematic search was conducted on PubMed, Embase, Scopus, and Web of Science until September 2024. Thirteen studies were included in total, one of which was an RCT, and the others were retrospective studies.

Results: According to our findings, MBS was linked to decreased risk of peri-prosthetic joint infection in 853 MBS vs. 835 non-MBS patients (OR: 0.55, 95% CI : 0.31, 0.97, P value: 0.04), deep venous thromboembolism in 1074 MBS vs. 11948 non-MBS patients (OR: 0.50, 95% CI: 0.28, 0.86, P value: 0.01), and shorter length of hospital stay in 2,221 MBS vs. 12,201 non-MBS patients (mean difference: -0.42 days, 95% CI : -0.71, -0.13, P value<0.001) after TKA/THA. Aseptic loosening, blood transfusion, peri-prosthetic fracture, postoperative manipulation, readmission, reoperation, dislocation, pulmonary thromboembolism, revision, and wound complications were not significantly associated with MBS.

Conclusion: MBS prior to TKA/THA can considerably reduce some post-operative complications, such as the risk of PJI, DVT, and LOS at the hospital. It can be offered to patients with severe obesity before undergoing TKA/THA.



Cite this article as: Shari’at Moghani M, Esparham A, Mahdinezhad Kashani M, Einafshar N, Radboy M, Ghamari MJ, et al. Impact of prior metabolic and bariatric surgery on outcomes of total knee and total hip arthroplasty: a systematic review and meta-analysis. Arch Iran Med. 2025;28(8):461-471. doi: 10.34172/aim.34291
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Submitted: 26 Mar 2025
Revision: 04 Jul 2025
Accepted: 12 Jul 2025
ePublished: 01 Aug 2025
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