1. Younger age 🔴First up, we know that obesity increases the likelihood of joint replacement surgery at an
earlier age.Indeed, a high BMI can lead to:
- Hip replacement up to 10 years earlier.
- Knee replacement up to
13 years earlier.Crumbs.
That’s compared to people with a normal BMI.
NOT an argument against delaying surgery unnecessarily.
BUT an argument for tackling high body mass
ASAP.
Delaying joint replacement is the first argument for Optimising Bodyweight.2. Worse outcomes 🔴 Second of all, we know that morbidly obese patients…
..those people with a BMI greater than 35..
Have worse pain and function…
..after joint replacement.
They begin at a lower starting point
Get a similar gain to everyone else.
BUT that gain is to a
worse result.A better outcome is the second argument for optimising bodyweight. 3. Higher risk of complications 🔴Third, and, I think, most important of all, is the higher risk of complications.
If an obese patient really needs joint replacement and is well prepared,
..then joint replacement can be the right choice.
One concern is the higher chance of repeat surgery.Revision rates are higher as the joint replacement is
more likely to fail. Or suffer complications that you have to live with.
That is the risk of something going wrong.
Top of the list is the biggest worry of all:
INFECTION Obesity increases the risk of infection
more than three-fold.AND complicates 1 in 7 operations when wrapped up with
uncontrolled metabolic syndrome.Metabolic syndrome is:
Central obesity (BMI > 30kg/m2) with 2 out of:
- High blood fat or
cholesterol- High
blood pressure, or
-
Diabetes.
In one study, the risk of infection with metabolic syndrome was over 14%
Compared to 0.8% without.
A
HUGE difference
Minimising the risk of life changing problems is argument number three for optimising bodyweight. Earlier joint replacement,
Worse pain and function after and
Higher chance of a negatively life changing event.
These are the 3 arguments for Optimising Bodyweight.
