Lan Vu, Noah J. Switzer, D?Arcy C. Durand, Douglas Hedden and Shahzeer Karmali
Joint Osteoarthritis (OA) is a major source of morbidity and disability in the aging population. It is especially a concern to overweight individuals, as obesity is an important risk factor for the development of OA. The relationship between obesity and the development of joint damage is not purely the result of mechanical forces as pathologic inflammatory markers have been implicated in the process as well. Recent clinical practise guidelines state that weight-loss leads to functional improvement in joint pain. It can then be expected that bariatric surgery, the only proven long-term weight-loss modality in the morbidly obese, should have a similar effect. However, the improvement in OA post-surgery is not as drastic in comparison to the change in other obesity-related co-morbidities. Bariatric surgery, however, can be used in conjunction with orthopaedic surgery to ultimately treat OA through joint replacement. Effective weight-loss, as achieved through bariatric surgery, can improve post-operative outcomes in the obese population, making poor surgical candidates into acceptable ones. In this editorial, we explore the relationship between obesity and osteoarthritis and the roles of combining bariatric and orthopaedic surgeries.