The associations between bariatric surgery and hip or knee arthroplasty, and hip or knee osteoarthritis: Propensity score-matched cohort studies
Objective: To investigate the associations between bariatric surgery and hip or knee arthroplasty, and secondary care hip or knee osteoarthritis (OA). Methods: We performed cohort studies using data from Swedish nationwide healthcare registries. Patients aged 18–79 years who underwent bariatric surg...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-06-01
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| Series: | Osteoarthritis and Cartilage Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2665913122000176 |
| _version_ | 1828821533158539264 |
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| author | Theresa Burkard Dag Holmberg Per Wretenberg Anders Thorell Thomas Hügle Andrea M. Burden |
| author_facet | Theresa Burkard Dag Holmberg Per Wretenberg Anders Thorell Thomas Hügle Andrea M. Burden |
| author_sort | Theresa Burkard |
| collection | DOAJ |
| description | Objective: To investigate the associations between bariatric surgery and hip or knee arthroplasty, and secondary care hip or knee osteoarthritis (OA). Methods: We performed cohort studies using data from Swedish nationwide healthcare registries. Patients aged 18–79 years who underwent bariatric surgery between 2006 and 2019 were matched on their propensity score (PS) to up to 2 obese patients (“unexposed episodes”) in risk-set sampling. After a 1-year run-in period, episodes were followed in an “as-treated” approach. Using Cox proportional hazard regression, we calculated hazard ratios (HR) with 95% confidence intervals (CIs) of hip or knee arthroplasty overall and in subgroups of age, sex, joint location, arthroplasty type, bariatric surgery type, and by duration of follow-up if proportional hazard assumptions were violated. In a secondary cohort, we assessed the outcome incident secondary care hip or knee osteoarthritis (OA). Results: Among 39‘392 bariatric surgery episodes when compared to 61’085 PS-matched unexposed episodes (47′594 unique patients), the risk of hip or knee arthroplasty was strongest increased within the first three years of follow-up (HR 1.79, 95% CI 1.56–2.07), decreased thereafter, but remained elevated throughout follow-up. In a secondary cohort of 37′929 exposed when compared to 58′600 PS-matched unexposed episodes, the risk of hip or knee osteoarthritis was decreased (HR 0.84, 95% CI 0.79–0.90). Conclusion: Bariatric surgery is associated with increased risks of hip or knee arthroplasty, but also with decreased risks of secondary care OA. This contradiction supports the hypothesis that bariatric surgery may act as an enabler for hip or knee arthroplasty. |
| first_indexed | 2024-12-12T12:56:04Z |
| format | Article |
| id | doaj.art-fff1de73c5bb408ab81a008b9f333f7c |
| institution | Directory Open Access Journal |
| issn | 2665-9131 |
| language | English |
| last_indexed | 2024-12-12T12:56:04Z |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Osteoarthritis and Cartilage Open |
| spelling | doaj.art-fff1de73c5bb408ab81a008b9f333f7c2022-12-22T00:23:53ZengElsevierOsteoarthritis and Cartilage Open2665-91312022-06-0142100249The associations between bariatric surgery and hip or knee arthroplasty, and hip or knee osteoarthritis: Propensity score-matched cohort studiesTheresa Burkard0Dag Holmberg1Per Wretenberg2Anders Thorell3Thomas Hügle4Andrea M. Burden5ETH Zurich, Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, Zurich, SwitzerlandUpper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, SwedenDepartment of Orthopaedics, Faculty of Medicine and Health, Örebro University, Örebro, SwedenDepartment of Clinical Science, Danderyd Hospital, Karolinska Institutet; Stockholm, Sweden; Department of Surgery, Ersta Hospital, Stockholm, SwedenDepartment of Rheumatology, Lausanne University Hospital, And University of Lausanne, Lausanne, SwitzerlandETH Zurich, Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, Zurich, Switzerland; Corresponding author. Pharmacoepidemiology, Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, Federal Institute of Technology (ETH) Zurich, Vladimir-Prelog-Weg 1-5/10, CH, 8093, Zurich, Switzerland.Objective: To investigate the associations between bariatric surgery and hip or knee arthroplasty, and secondary care hip or knee osteoarthritis (OA). Methods: We performed cohort studies using data from Swedish nationwide healthcare registries. Patients aged 18–79 years who underwent bariatric surgery between 2006 and 2019 were matched on their propensity score (PS) to up to 2 obese patients (“unexposed episodes”) in risk-set sampling. After a 1-year run-in period, episodes were followed in an “as-treated” approach. Using Cox proportional hazard regression, we calculated hazard ratios (HR) with 95% confidence intervals (CIs) of hip or knee arthroplasty overall and in subgroups of age, sex, joint location, arthroplasty type, bariatric surgery type, and by duration of follow-up if proportional hazard assumptions were violated. In a secondary cohort, we assessed the outcome incident secondary care hip or knee osteoarthritis (OA). Results: Among 39‘392 bariatric surgery episodes when compared to 61’085 PS-matched unexposed episodes (47′594 unique patients), the risk of hip or knee arthroplasty was strongest increased within the first three years of follow-up (HR 1.79, 95% CI 1.56–2.07), decreased thereafter, but remained elevated throughout follow-up. In a secondary cohort of 37′929 exposed when compared to 58′600 PS-matched unexposed episodes, the risk of hip or knee osteoarthritis was decreased (HR 0.84, 95% CI 0.79–0.90). Conclusion: Bariatric surgery is associated with increased risks of hip or knee arthroplasty, but also with decreased risks of secondary care OA. This contradiction supports the hypothesis that bariatric surgery may act as an enabler for hip or knee arthroplasty.http://www.sciencedirect.com/science/article/pii/S2665913122000176Bariatric surgeryOsteoarthritisArthroplastyObesityWeight loss |
| spellingShingle | Theresa Burkard Dag Holmberg Per Wretenberg Anders Thorell Thomas Hügle Andrea M. Burden The associations between bariatric surgery and hip or knee arthroplasty, and hip or knee osteoarthritis: Propensity score-matched cohort studies Osteoarthritis and Cartilage Open Bariatric surgery Osteoarthritis Arthroplasty Obesity Weight loss |
| title | The associations between bariatric surgery and hip or knee arthroplasty, and hip or knee osteoarthritis: Propensity score-matched cohort studies |
| title_full | The associations between bariatric surgery and hip or knee arthroplasty, and hip or knee osteoarthritis: Propensity score-matched cohort studies |
| title_fullStr | The associations between bariatric surgery and hip or knee arthroplasty, and hip or knee osteoarthritis: Propensity score-matched cohort studies |
| title_full_unstemmed | The associations between bariatric surgery and hip or knee arthroplasty, and hip or knee osteoarthritis: Propensity score-matched cohort studies |
| title_short | The associations between bariatric surgery and hip or knee arthroplasty, and hip or knee osteoarthritis: Propensity score-matched cohort studies |
| title_sort | associations between bariatric surgery and hip or knee arthroplasty and hip or knee osteoarthritis propensity score matched cohort studies |
| topic | Bariatric surgery Osteoarthritis Arthroplasty Obesity Weight loss |
| url | http://www.sciencedirect.com/science/article/pii/S2665913122000176 |
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