ROUX-EN-WHY? WHAT THE ORTHOPAEDIC SURGEON NEEDS TO KNOW ABOUT BARIATRIC SURGERY

Bariatric surgical procedures can be subdivided into restrictive, malabsorptive, and restrictive and malabsorptive categories. The greatest amount of excess weight loss occurs by 18 to 24 months following these procedures and can exceed 70% in certain procedures. Postoperative malabsorption of fat-soluble vitamins and protein is most common in patients with combined restrictive and malabsorptive procedures such as biliopancreatic diversion. Patients undergoing a bariatric surgical procedure are at an increased risk of fracture due to changes in bone metabolism, with the potential risk for decreased fracture-healing that has not been extensively studied. Regardless of the improvement in body mass index, patients undergoing a bariatric surgical procedure appear to remain at higher risk for complications with total joint arthroplasty when compared with the general population.