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Preoperative Weight Loss Before Total Shoulder Arthroplasty Does Not Impact Postoperative Outcomes

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Preoperative Weight Loss Before Total Shoulder Arthroplasty Does Not Impact Postoperative Outcomes

Stephen C. Weber, MD, UNITED STATES Alexander R. Zhu, BA, UNITED STATES Eve R. Glenn, ScB, UNITED STATES Henry Fox, MD, UNITED STATES James H. Padley, BS, UNITED STATES Edward G. McFarland, MD, FAAOS, UNITED STATES

The Johns Hopkins School of Medicine, Baltimore, Maryland, UNITED STATES

2025 Congress ePoster Presentation 2025 Congress Not yet rated

Anatomic Location

Shoulder Glenohumeral

Diagnosis / Condition

Arthritis

Treatment / Technique

Arthroplasty

Summary: Unlike evidence that preoperative weight loss leads to better outcomes in joint arthroplasty of the lower extremity, preoperative weight loss does not significantly impact 30-day postoperative outcomes following TSA

Background

Total shoulder arthroplasty (TSA) is an increasingly prevalent treatment for glenohumeral arthritis. Obesity is a recognized risk factor in TSA, contributing to higher complication rates. Although some orthopaedic surgeries have implemented body mass index (BMI)-based eligibility cutoffs, no standardized preoperative criteria for TSA exists. This study investigates the impact of preoperative weight loss on postoperative outcomes in TSA patients.

Methods

A retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database from 2011 to 2020 was conducted. Patients undergoing TSA were categorized into two different weight loss groups (preoperative weight loss of >10% within 6 months of surgery or no weight loss). A subanalysis stratifying by weight loss was performed on obese patients (BMI ≥ 30 kg/m2). Demographics, comorbidities, preoperative lab values, and postoperative outcomes were analyzed using univariate and multivariate models adjusted for significant covariates.

Results

Patients who lost significant weight preoperatively were more likely to be discharged to a non-home setting. However, this association disappeared once adjusting for relevant covariates. In the subpopulation of only obese patients, there was no association between preoperative weight loss and any 30-day postoperative outcomes (all P-values > 0.05).

Discussion

Unlike evidence that preoperative weight loss leads to better outcomes in joint arthroplasty of the lower extremity, preoperative weight loss does not significantly impact 30-day postoperative outcomes following TSA in the overall population or patients with obesity. Further research is needed to develop preoperative guidelines that consider BMI and other relevant comorbidities.

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Preoperative Weight Loss Before Total Shoulder Arthroplasty Does Not Impact Postoperative Outcomes

Preoperative Weight Loss Before Total Shoulder Arthroplasty Does Not Impact Postoperative Outcomes

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Preoperative Weight Loss Before Total Shoulder Arthroplasty Does Not Impact Postoperative Outcomes

Preoperative Weight Loss Before Total Shoulder Arthroplasty Does Not Impact Postoperative Outcomes

Background

Methods

Results

Discussion