Implementing Weight Loss Before Total Joint Arthroplasty Using A Remote Dietitian and Mobile App: A Randomized, Control Trial

Principal Investigator: Antonia Chen

Authors: Prabhavi Denagamage, Daniel Lamanna, Michael Seward, Antonia Chen
Lay Abstract
Scientific Abstract

INTRODUCTION

Upcoming total joint arthroplasty (TJA) offers motivation for patients with severe obesity to lose weight to optimize clinical outcomes. This study assessed the efficacy of a preoperative weight loss intervention using a remote dietitian and mobile app.

 

METHODS

Participants with a body mass index (BMI)>40–47kg/m2 scheduled for TJA were recruited. Participants randomized to the control group received standard care (nutritionist and/or physical therapy) and those randomized to the intervention group were connected with a remote dietician.

 

Outcomes were weight change from baseline to 12 weeks, along with behavioral and functional parameters. Outcome and demographic data were collected using medical chart review, along with pre- and post-intervention surveys and phone interviews. Laboratory tests were used to assess nutritional status.

 

RESULTS

Patients receiving standard care had a mean baseline BMI of 43.7kg/m2±2.3 and 43.4kg/m2±5.2 after 12 weeks. Patients in the intervention group had a mean baseline BMI of 43.5kg/m2±1.7 and BMI of 44.3kg/m2±5.5 after 12 weeks. Both groups lost weight, although the difference was not significantly different.

 

CONCLUSION

Visits with a remote dietician and tracking one’s diet offer opportunities for preoperative weight loss that may otherwise be unavailable.

Clinical Implications
An upcoming total joint arthroplasty offers motivation for patients with severe obesity to lose weight to optimize clinical outcomes. Visits with a remote dietician and tracking one’s diet offer opportunities for preoperative lifestyle changes that may otherwise be unavailable.

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