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J Arthroplasty. 2014 Mar;29(3):458-64.e1. doi: 10.1016/j.arth.2013.07.030. Epub 2013 Sep 7.

The impact of pre-operative weight loss on incidence of surgical site infection and readmission rates after total joint arthroplasty.

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Joint Doctoral Program Epidemiology, San Diego State University/University of California, San Diego, California.
Department of Family and Preventive Medicine, University of California San Diego School of Medicine, San Diego California.
Department of Biostatistics, University of California San Diego School of Medicine, San Diego, California.
Graduate School of Public Health, San Diego State University, San Diego, California.
School of Exercise & Nutritional Sciences, San Diego State University, San Diego, California.
Southern California Permanente Medical Group, Department of Orthopaedic Surgery, San Diego, California.


This study characterized a cohort of obese total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients (1/1/2008-12/31/2010) and evaluated whether a clinically significant amount of pre-operative weight loss (5% decrease in body weight) is associated with a decreased risk of surgical site infections (SSI) and readmissions post-surgery. 10,718 TKAs and 4066 THAs were identified. During the one year pre-TKA 7.6% of patients gained weight, 12.4% lost weight, and 79.9% remained the same. In the one year pre-THA, 6.3% of patients gained weight, 18.0% lost weight, and 75.7% remained the same. In TKAs and THAs, after adjusting for covariates, the risk of SSI and readmission was not significantly different in the patients who gained or lost weight pre-operatively compared to those who remained the same.


Total hip arthroplasty; Total knee arthroplasty; infection; obesity; readmission; weight loss

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