Is obesity a reason to avoid joint replacement surgery?

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“Come again while you’ve misplaced 40 kilos.” That’s one thing overweight sufferers have heard typically when being evaluated for a hip or knee alternative for extreme arthritis. And generally the advice is to lose much more — 50, 75, and even 100 kilos… as if that’s a straightforward or real looking prospect.

As you would possibly anticipate, sufferers listening to this typically really feel disillusioned and disheartened. In spite of everything, most have already tried onerous to drop some pounds with restricted success. Their arthritis ache impairs their skill to train, and lowering exercise has contributed to their weight achieve. So being instructed to lose vital weight earlier than they are often thought of for joint surgical procedure sounds so much like being instructed it’s simply not going to occur.

Why ought to weight problems preclude joint surgical procedure?

Whereas the surgeon’s suggestions could also be disappointing, the rationale appears sound: folks carrying loads of extra weight have lengthy been thought of at larger danger for issues, and fewer more likely to expertise the profound ache aid anticipated from this main operation. Certainly, a number of research describe larger charges of infections and dislocations and decrease charges of excellent outcomes after hip or knee alternative among the many overweight, particularly the severely overweight.

Importantly, many of those research are greater than a decade outdated, and newer research are starting to color a distinct image. A current research on the dangers and advantages of joint alternative among the many overweight sheds new — and constructive — gentle on a difficulty that impacts many hundreds of individuals.

A brand new research means that being overweight mustn’t preclude joint alternative

Researchers analyzed the outcomes of greater than 5,000 folks having hip or knee alternative surgical procedure, evaluating ache and performance earlier than and 6 months after surgical procedure. Right here’s what they discovered:

  • Those that have been probably the most overweight (about 25% of these within the research) had extra ache and poorer operate previous to surgical procedure than those that have been leaner.
  • The quantity of practical achieve in overweight people six months after joint alternative was vital, and just like that skilled by those that weren’t overweight.
  • Ache aid was larger among the many most overweight than different weight teams. After surgical procedure, ache ranges have been related in all weight teams.

The authors conclude that “weight problems in itself shouldn’t be a deterrent to present process whole joint alternative to alleviate signs.” Nevertheless, the potential for extra issues have to be thought of as properly, one thing this research didn’t formally look at.

Given the excessive and rising charges of weight problems and arthritis on this nation, the outcomes of this research will seemingly apply to many individuals. And so they counsel that surgeons ought to change expectations about what surgical procedure has to supply overweight people with extreme arthritis.

The underside line

Whereas avoiding weight problems within the first place remains to be preferable, there may be rising proof that the advantages of joint alternative surgical procedure should not restricted to those that are lean. If this new analysis is confirmed by others, we may even see fewer overweight folks turned down for joint alternative surgical procedure sooner or later.

Comply with me on Twitter @RobShmerling

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