DOI: 10.1093/bjs/znad258.119 ISSN:

579 Audit to Measure if >5% Reduction in Weight Occurred, as Recommended by the National Institute of Health and Clinical Excellence (NICE), for Patients Suffering from Osteoarthritis Before Their Scheduled Total Joint Replacements, at Darwen

A Sarma, S Mustafa
  • Surgery



Osteoarthritis causes damage to synovial joints, manifesting as pain, loss of function, and disability. A high BMI is correlated with an increased incidence of osteoarthritis, for which NICE recommends a >5% (ideally >10%) decrease in baseline weight to improve pain and functionality. This audit aims to measure Darwen Health Link’s adherence to NICE guidelines 226 “Osteoarthritis in over 16s: diagnosis and management” for the management of osteoarthritis patients regarding weight-loss.


This audit analysed 15 osteoarthritis patients with a BMI>30 who underwent total joint replacements from November 2021 to November 2022. Patient records were analysed for their weight management from 3-12 months prior to surgery, up till their surgery period to assess: if weight-loss advice was provided, and if >5% weight-loss took place. Standards were designated per clinician recommendations and NICE guidelines.


All osteoarthritic patients (n = 15) were given weight-loss advice at presentations before surgery. However, only 20% (n = 3) of patients lost >5% of their baseline weight before their joint replacements, against the 50% standard. Therefore, interventions to improve weight-loss in patients and clinician guidance were implemented. These include a targeted poster, detailed weight-loss advice packs for patients, and clinician education about weight-loss programmes available locally.


The first part of the audit indicates suboptimal performance by Darwen Health Link. Their performance will be re-audited in 3 months post-interventional implementation. Reducing osteoarthritis’s burden on patients in primary care can significantly reduce pain and the need for surgery.

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