Improvement in knee osteoarthritis pain and function following bariatric surgery: 5-year follow-up

Background: Weight loss through bariatric surgery improves short-term knee pain and symptoms in patients with osteoarthritis. There is little research regarding whether patients maintain symptomatic improvement in long-term follow-up after bariatric surgery. Objectives: We hypothesized that bariatric surgery is a reliable method of maintaining weight loss in these patients with continued improvements in knee pain and symptoms at 5-year follow-up compared with baseline. Setting: University hospital. Methods: A 5-year prospective observational study was performed in patients with symptoms and radiographic evidence of knee osteoarthritis who were undergoing bariatric surgery. The Western Ontario and McMaster Universities Index of Osteoarthritis and Knee Osteoarthritis Outcome Score Surveys were administered at baseline, 6 months, 12 months, 2 years, and 5 years. Patients who met all inclusion criteria and followed up at baseline, 6 months, 1 year, and 5 years were included in the study (n = 13). Statistical analysis was performed using Student t and Wilcoxon signed rank tests. Results: Patients on average maintained a percent total weight loss of 22.3% at 5-year follow-up (P <.0001). There was a statistically significant improvement from baseline in all subscales—pain, stiffness, and physical function—as measured by Western Ontario and McMaster Universities at 6 months, 1 year, and 5 years. A statistically significant change in pain (P =.0005) and function/activities of daily living (P =.0088) was maintained at 5-year follow-up as measured by the Knee Osteoarthritis Outcome Score. Conclusions: Bariatric surgery is a reliable method to maintain weight loss, reduce pain and stiffness, and improve function in patients with knee osteoarthritis at 5-year follow-up.