Morbid Obesity is the leading public health epidemic of the industrialized world with bariatric surgery as the only effective and enduring treatment for this disease. Gastric Bypass is known to be very effective for weight loss and can also improve obesity related comorbidities like joint disease. Joint disease may be difficult to assess without radiographs. We hypothesized that gastric bypass patients would demonstrate substantial improvement in muscle-skeletal quality of life.
In 2007 at an academic center, 89 patients underwent laparoscopic roux en y gastric bypass by a single surgeon and had the SMFA Questionnaire administered preoperatively and at 3, 6, and 12 months postoperatively. The SMFA (Skeletal-Musculo Functional Assessment) is a disease-specific quality of life instrument that has been previously validated by the American Academy of Orthopedic Surgery. This is the first use of SMFA outside of Orthopedic Surgery.
Study patients were 82% female with an average age of 43 and BMI of 49. Preoperative SMFA results were significantly lower than societal norms (45 vs. 87). Both at 3, 6, and 12 months post-operatively, there were significant improvements in all SMFA domain scores including overall, upper/lower extremity, and cervical/thoracic/lumbar spine. Overall improvement from preop to 12 months was profound from 45 to 98. In addition, a trend was noted for correlation between SMFA scores and weight loss.
Obese patients have a significantly reduced muscle-skeletal quality of life that is substantially improved after gastric bypass surgery. The SMFA instrument is easily administered and can be useful in assessing resolution of joint disease.
Program Number: P101