Academy of Medical Sciences of I.R. Iran Archives of Iranian Medicine 1029-2977 28 8 2025 08 01 Impact of Prior Metabolic and Bariatric Surgery on Outcomes of Total Knee and Total Hip Arthroplasty: A Systematic Review and Meta-analysis 461 471 10.34172/aim.34291 EN Mahta Shari’at Moghani https://orcid.org/0009-0001-2226-4651 Ali Esparham https://orcid.org/0000-0003-0959-9817 Mohammad Mahdinezhad Kashani https://orcid.org/0000-0001-6887-1134 Negar Einafshar https://orcid.org/0000-0003-4689-492X Mahsa Radboy https://orcid.org/0009-0009-8656-4889 Mohammad Javad Ghamari https://orcid.org/0000-0002-0351-6219 Tooraj Zandbaf https://orcid.org/0000-0002-4882-5058 Journal Article 10.34172/aim.34291 2025 03 26 2025 07 12 Background: The current study evaluated the effects of prior metabolic and bariatric surgery (MBS) on complications after total knee/hip arthroplasty (TKA/THA). We performed a meta-analysis to assess the impact of prior MBS on TKA/THA outcomes. Methods: Our systematic search was conducted on PubMed, Embase, Scopus, and Web of Science until September 2024. Thirteen studies were included in total, one of which was an RCT, and the others were retrospective studies. Results: According to our findings, MBS was linked to decreased risk of peri-prosthetic joint infection in 853 MBS vs. 835 non-MBS patients (OR: 0.55, 95% CI : 0.31, 0.97, P value: 0.04), deep venous thromboembolism in 1074 MBS vs. 11948 non-MBS patients (OR: 0.50, 95% CI: 0.28, 0.86, P value: 0.01), and shorter length of hospital stay in 2,221 MBS vs. 12,201 non-MBS patients (mean difference: -0.42 days, 95% CI : -0.71, -0.13, P value<0.001) after TKA/THA. Aseptic loosening, blood transfusion, peri-prosthetic fracture, postoperative manipulation, readmission, reoperation, dislocation, pulmonary thromboembolism, revision, and wound complications were not significantly associated with MBS. Conclusion: MBS prior to TKA/THA can considerably reduce some post-operative complications, such as the risk of PJI, DVT, and LOS at the hospital. It can be offered to patients with severe obesity before undergoing TKA/THA.