Evidence map›Paper›PMID 35211834›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2022

Morbid Obesity and Severe Knee Osteoarthritis: Which Should Be Treated First?

Stephanie Purcell, Intekhab Hossain, Bradley Evans, Geoff Porter, Glen Richardson, James Ellsmere

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
7.4field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. COVID-19 Disruption Of Knee Arthroscopies.The Iowa orthopaedic journal · 2025
    Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Stephanie PurcellDepartment of Surgery, Dalhousie University, 1276 South Park, Vic 823, Halifax, NS, B3H 2Y9, Canada.
Intekhab HossainDepartment of Surgery, Dalhousie University, 1276 South Park, Vic 823, Halifax, NS, B3H 2Y9, Canada.
Bradley EvansDepartment of Surgery, Dalhousie University, 1276 South Park, Vic 823, Halifax, NS, B3H 2Y9, Canada.
Geoff PorterDepartment of Surgery, Dalhousie University, 1276 South Park, Vic 823, Halifax, NS, B3H 2Y9, Canada.
Glen RichardsonDepartment of Surgery, Dalhousie University, 1276 South Park, Vic 823, Halifax, NS, B3H 2Y9, Canada.
James EllsmereDepartment of Surgery, Dalhousie University, 1276 South Park, Vic 823, Halifax, NS, B3H 2Y9, Canada. James.Ellsmere@dal.ca.
Dalhousie University · CAMemorial University of Newfoundland · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere are limited prospective data, and conflicting retrospective data, providing guidance on how to optimally manage patients with morbid obesity and severe knee osteoarthritis. This study sought to review the effect of bariatric surgery on knee pain and knee surgery 30-day outcomes, as well as assess whether the sequence of bariatric and knee surgery has any effect on 30-day complications.

methodsA retrospective chart review of all patients undergoing laparoscopic sleeve gastrectomy (LSG) from July 2006 to July 2016 at a university hospital was performed. Patients with knee pain or knee surgery (pre- or post-LSG) were identified using bariatric and orthopedic clinic notes. Those who had improvement in knee pain following LSG resulting in removal from orthopedic surgery waitlist were identified. We also assessed surgical outcomes in patients undergoing knee arthroscopy or total knee arthroplasty (TKA) followed by LSG compared to patients undergoing LSG followed by knee arthroscopy or TKA.

resultsDuring our study timeframe, 355 patients underwent LSG. Knee pain was documented in 150 (42.2%) patients, and orthopedic surgery consultation was completed for 57 (38.0%) patients with knee pain. Orthopedic intervention was performed prior to LSG for 24 patients and after LSG for 27 patients. Procedures were a combination of arthroscopy (18) and TKA (33). Six patients were removed from the waitlist for TKA following LSG due to resolution of symptoms. Order of interventions did not affect 30-day complications for patients undergoing LSG and arthroscopy (16% arthroscopy first, 0% LSG first, p = 0.43). A higher rate of LSG complications was noted in patients who underwent TKA prior to LSG (25% vs 0%, p = 0.04). There were no differences in TKA complications (8.3% TKA first, 4.8% LSG first, p = 1.00).

conclusionIn a small number of patients with morbid obesity and severe knee osteoarthritis, orthopedic intervention can be delayed and potentially avoided by undergoing LSG. In our study, 6/57 (10.5%) of patients with orthopedic consultation prior to LSG saw resolution of symptoms of knee pain. Referral to bariatric surgery should be considered for patients with morbid obesity and severe knee osteoarthritis.

Indexed as

Bariatric SurgeryLaparoscopyObesity, MorbidOsteoarthritis, KneeGastrectomyHumansPainPostoperative ComplicationsProspective StudiesRetrospective StudiesTreatment OutcomeWeight LossBariatric surgeryComplicationsMorbid obesityOsteoarthritisSleeve gastrectomyTotal knee arthroplasty

Identifiers

PMID35211834
PMCPMC9296424
OpenAlexW4214488767

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.