Obesity can pose many problems when it comes to orthopedic issues and orthopedic surgery. Not only can obesity worsen or accelerate the progression of many orthopedic conditions, such as arthritis, but obesity is also associated with an increase in surgical complications. Obesity is defined as a BMI (Body Mass Index) greater than 30 and extreme obesity is defined as a BMI of greater than 40. The higher your BMI, the more complications that can arise surrounding surgery. (Please see chart at end of article to calculate your BMI).
Obesity, mainly extreme obesity (BMI>40), puts you at a much higher risk of complications both intra-operatively and post-operatively. Intra-operative complications associated with obesity include difficult anesthesia intubation, nerve/vessel damage due to decreased visibility, and increased surgical time due to a more technically difficult procedure. Other serious complications that can arise surrounding surgery include poor wound healing, surgical wound infection, failed orthopedic hardware, heart attack, stroke, blood clots, and longer recovery time. These are all complications that must be taken into consideration prior to undergoing a total joint surgery for any patient, but especially for those with a BMI greater than 40.
So this all begs the question: if an obese patient is considering total joint surgery, is going through with the surgery a wise decision? This can be a difficult question to answer as every patient poses different circumstances and different personal risk factors. This is a question that is best to discuss with your team of physicians (surgeon, PCP, etc.) in order to decide what is best for you. However, in nearly every case, weight loss prior to surgery is ideal for the best possible outcome. Every pound of weight you lose takes up to 4 pounds of stress off your knee joint. Not only can this weight loss potentially decrease the pain pre-operatively, but losing weight will also decrease the stress you place on a total joint replacement post-operatively. Therefore, weight loss would ultimately increase the longevity of your total joint, lessen your recovery time, and improve your quality of life moving forward.
At Three Rivers Orthopedic Associates, we are here to assist you and help you make the best decision possible when it comes to you, your orthopedic needs, and your overall health. So, if you have been thinking about total joint surgery due to life-altering pain in your knees, shoulders, or hips, please give us a call so we can help you and discuss the next steps in your care. Obesity is not a complete contraindication for total joint surgery, so be sure to discuss your particular situation with your surgeon.
We know losing weight can be difficult when you are hindered by orthopedic pain and physical limitations. We are happy to help you explore all options and possibly refer you to other solutions that may be right for you, such as the Bariatric Surgery Center of Excellence at UPMC. Again, an open conversation with one of our elite surgeons is where we recommend you start. This article is not meant to scare you, but the weight loss conversation prior to undergoing surgery will likely improve your quality of life and possibly even save your life.