Nutritional Counseling Program for Morbidly Obese Patients Enables Weight Optimization for Safe Total Joint Arthroplasty.

Nutritional Counseling Program for Morbidly Obese Patients Enables Weight Optimization for Safe Total Joint Arthroplasty. Orthopedics. 2020 Jun 04;:1-7 Authors: Lingamfelter M, Orozco FR, Beck CN, Harrer MF, Post ZD, Ong AC, Ponzio DY Abstract Obesity affects one-third of total joint arthroplasty (TJA) patients and is the most common modifiable risk factor for increased complications in the TJA population. The authors' institution implemented a body mass index (BMI) cutoff of 40 kg/m2 to define appropriate TJA candidates. Patients above the cutoff were referred for nutritional counseling. The study objective was to evaluate the efficacy of this protocol in optimizing patient BMI for safe and successful TJA. Between 2016 and 2018, the authors examined 133 patients (mean age, 62.6 years) with a BMI greater than 40 kg/m2 seeking TJA (94 knee, 39 hip) seen by an arthroplasty surgeon and then a dietitian. Outcomes included weight loss, change in BMI, duration of counseling, and surgical status. For postoperative patients, 90-day complications were recorded. A total of 102 (92%) patients achieved weight loss during a mean 154 days (range, 8-601 days). Patients lost a mean of 17 lb, lowering their BMI by 2.7 points (range, +6.3 to -17.7 points). Twenty-two patients discontinued nutritional counseling after 1 visit, most commonly secondary to cost when not covered by insurance. Seventy-one patients successfully underwent TJA, representing 64...
Source: Orthopedics - Category: Orthopaedics Authors: Tags: Orthopedics Source Type: research