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Pediatrics. 2019 Dec;144(6). pii: e20191399. doi: 10.1542/peds.2019-1399. Epub 2019 Nov 19.

Musculoskeletal Pain, Physical Function, and Quality of Life After Bariatric Surgery.

Author information

1
Sidra Medicine, Doha, Qatar; sbouttabaku@sidra.org.
2
Weill Cornell Medicine-Qatar, Doha, Qatar.
3
Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
4
Medical School, University of Minnesota, Minneapolis, Minnesota.
5
Nationwide Children's Hospital, Columbus, Ohio.
6
The Ohio State University, Columbus, Ohio.
7
Children's Hospital Colorado, Aurora, Colorado.
8
University of Colorado, Denver, Colorado.
9
Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
10
University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
11
Sanford Research and School of Medicine and Health Sciences, University of North Dakota, Fargo, North Dakota.
12
Women and Children's Hospital, Buffalo, New York.
13
University of Buffalo, Buffalo, New York; and.
14
University of Cincinnati, Cincinnati, Ohio.

Abstract

OBJECTIVES:

To evaluate the longitudinal effects of metabolic and bariatric surgery (MBS) on the prevalence of musculoskeletal and lower extremity (LE) pain, physical function, and health-related quality of life.

METHODS:

The Teen Longitudinal Assessment of Bariatric Surgery study (NCT00474318) prospectively collected data on 242 adolescents undergoing MBS at 5 centers over a 3-year follow-up. Joint pain and physical function outcomes were assessed by using the Health Assessment Questionnaire Disability Index, Impact of Weight on Quality of Life - Kids, and the Short Form 36 Health Survey. Adolescents with Blount disease (n = 9) were excluded.

RESULTS:

Prevalent musculoskeletal and LE pain were reduced by 40% within 12 months and persisted over 3 years. Adjusted models revealed a 6% lower odds of having musculoskeletal pain (odds ratio = 0.94, 95% confidence interval: 0.92-0.99) and a 10% lower odds of having LE pain (odds ratio = 0.90, 95% confidence interval: 0.86-0.95) per 10% reduction of BMI. The prevalence of poor physical function (Health Assessment Questionnaire Disability Index score >0) declined from 49% to <20% at 6 months (P < .05), Physical comfort and the physical component scores, measured by the Impact of Weight on Quality of Life - Kids and the Short Form 36 Health Survey, improved at 6 months postsurgery and beyond (P < .01). Poor physical function predicted persistent joint pain after MBS.

CONCLUSIONS:

Joint pain, impaired physical function, and impaired health-related quality of life significantly improve after MBS. These benefits in patient-reported outcomes support the use of MBS in adolescents with severe obesity and musculoskeletal pain and suggest that MBS in adolescence may reverse and reduce multiple risk factors for future joint disease.

PMID:
31744891
PMCID:
PMC6889948
[Available on 2020-12-01]
DOI:
10.1542/peds.2019-1399

Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: Dr Inge received honoraria and stock options from Standard Bariatrics and honoraria from UpToDate and Independent Medical Expert Consulting Services and served as a consultant for Zafgen, Inc, BioMedical Insights, and L&E Research, all outside the submitted work. Dr Harmon served on an advisory panel for Stryker Corporation from 1998 to 2015, unrelated to this project. Dr Dixon consulted for Apollo Endosurgery, Covidien, Bariatric Advantage, Nestle Health Science, Inova, and Novo Nordisk; the other authors have indicated they have no potential conflicts of interest to disclose.

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