Overweight and Obesity- A leading cause of knee replacement surgeries worldwide

Nowadays, obesity has become a global outbreak. Obesity is one of the major reasons for increasing the possibility of knee replacement surgery. Obesity has been connected to an increase in the number of patients having knee replacement surgery earlier in life. One study found that 77% of joint replacement patients under the age of 60 were obese, compared to only 26% of the overall population.

By Ezaz Rahaman

Updated on 18th, Nov'22

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Overview

The number of total knee replacement surgeries is increasing year after year, with even more projected in the future.

According to research, the major factor is an increase in obesity rates. Excess weight can place additional strain on the knees, resulting in joint problems.

Medical professionals say that losing just a few pounds can considerably reduce the signs of knee osteoarthritis and lower the likelihood of needing a knee replacement.


This article will discuss obesity and the problems associated with the knee in an obese population.

 

What effect does obesity have on your knee health?

Obesity and being overweight put you at risk for various potentially fatal health issues, including diabetes, cardiovascular disease, and cancer burdens. It also increases your chances of developing osteoarthritis and other musculoskeletal knee and hip diseases.

 

In the age group of 18 to 59 years, almost 52% went for total knee replacement (TKR).  Men and women from all age groups are affected. Compared to normal patients, obese patients are at an increased risk of knee replacement surgery. The younger patients are also more affected by it. Knee replacement surgery can be reduced by 31% if people adopt weight reduction strategies.

 

Obesity-related issues with your bones, muscles, and joints are so widespread that the Harvard T.H. Chan School of Public Health reports that 33% of all joint replacement surgeries involve an obese patient.

 

The link between obesity and knee discomfort is apparent. Excess weight strains your hips, knees, and the weight-bearing joints of your spine. The longer your joints are subjected to greater stress, the faster they deteriorate and become injured. The combination causes excruciating discomfort, making it difficult to stand or move freely and comfortably.

 

What is the connection between Obesity and Knee Replacement?

Every day, when we walk, stand, run, or climb, our legs' joints support our bodies' weight. According to our structure, the stresses experienced across the joint surfaces inside our hips and knees might be more than 7 times our body weight.

The more weight we carry, whether muscle or fat, the more strain we put on our hips and knees. This is one of the reasons why obese people are more likely to require knee replacements than patients with normal BMIs, and why the risk increases as your BMI rises.

 

Now you must think, can an obese person have knee replacement surgery?

 

Yes, According to Dr. Alwin Almeida, Orthopedic Surgeon in the Caribbean, 

 

An obese patient can have knee surgery, but the patient should be advised of the risk of complications such as infections and early loosening of the implants. They should be counseled to become more active after surgery to lose weight and reduce their BMI.

 

BMI for Knee Replacement

BMI, or body mass index, is a ratio that relates to a person's weight. Obesity is defined by the World Health Organization (WHO) as a body mass index (BMI) of greater than 30 kg/m2 that may impair a person’s health.  A BMI between 25 kg/m2 and 30 kg/m2 is defined as Overweight.

 

  • The optimum BMI range is between 20 and 25. A BMI of 25 or above is considered overweight and a BMI of 30 or higher is considered obese.
  • If your BMI is greater than 30, you may be at a higher risk of surgical and anesthesia problems.
  • A study concludes that having a BMI greater than 30 is a risk factor for needing a knee arthroplasty.
  • If the BMI is 40-45 or above, the risk to patients in terms of surgical complications and implant failure is high.

Dr. Alwin Almeida also mentioned that,

Patients with a body mass index (BMI) of 40 or higher are generally advised to lose weight before surgery since obese persons are at a higher risk of surgical complications. Obesity can lead to knee replacement failure if post-operative care and commitment to reducing BMI are not well managed. However, obesity is not an absolute contraindication to joint replacement surgery. Several studies have shown that total knee replacement in patients with a BMI between 30 and 39 has been successful with acceptable complication rates.

 

Can morbidly obese have successful knee replacement?

Total knee replacement is both safe and effective in morbidly obese patients. Obese patients do not need to lose weight before total joint replacement surgery, according to a study published in the Journal of Bone and Joint Surgery (Li et al.) in 2017. Even severely obese patients can be offered knee replacement surgery after thoroughly evaluating their condition and providing a realistic explanation of what to expect following surgery.

 

Can obesity lead to knee replacement failure?

Obesity has been linked to an increased risk of medical or surgical complications after joint replacement, such as wound healing issues and infection.

 

As a result, if the post-operative BMI is not carefully maintained, the knee replacement may fail. Regarding this, Dr. Alwin Almeida also said that

 

Obesity is not an absolute contraindication for knee replacement surgery.  Obese and non-obese patients with the following conditions are not recommended for surgery: 

Knee sepsis; previously untreated or chronic osteomyelitis; an ongoing remote source of infection; and absent and severe untreated or untreatable peripheral arterial disease.


 

 

Does losing weight help with knee replacement?

Healthy weight loss, while challenging, has numerous health benefits in addition to lowering the risks of surgery. Since there could be dangers based on your health and situation, your doctor can provide personalized advice on each of these possibilities.

 

 

So here, to conclude, obesity is an increasing worldwide problem. Proper measures should be taken to overcome them. Especially the young generation should take a healthy diet and pursue a healthy lifestyle to avoid being overweight and obese. Overall, evidence suggests obese patients are at increased risk of premature joint failure.

 

 

References:

https://www.healthline.com/

https://orthoinfo.aaos.org/  

https://www.theguardian.com/  

 

 

Frequently Asked Questions
Question and Answers (254)
Hello sir, my mother is having severe knee joint pain. She can't walk properly, cant stand for long time. In x ray there is gap between bones. In bhopal mp dr told for surgery. Should I go for it Or it may cure by non surgical procedure

Female | 62

from scenario you mentioned it looks like your mother has osteoarthritis of knee and has been advised knee replacement.

difficult to comment without xray and patient.
Dr. Sunny Dole's profile picture

Dr. Sunny Dole

I am having neck pain for 1 year 6 months now...i did every scans i did MRI , CT and even XRay found nothing....I did physiotherapy and even excercise for 3 months .... But still there is pain

Female | 21

ok. looks like there could be more to it. can you post your xray photo and MRI report photo.
Dr. Sunny Dole's profile picture

Dr. Sunny Dole

Sir I have scoliosis for past 7years is scoliosis surgery safe to do it

Male | 26

depending on degree of curvature, yes it should be done to avoid future problems as you seem young to me


Dr. Sunny Dole's profile picture

Dr. Sunny Dole

I am suffering with lower back pain with disc bulge at l5-s1 level..every doctor is suggesti g for surgery. But i am confused with different procedures microdiscectomy endoscopic with matrex, key hole . In confusion with all these procedures . Plz guide me with the details of all these kinds and which one is best for me

Female | 26

trust the surgeon and go ahead. outcome will be good with any mentioned procedure.


Dr. Sunny Dole's profile picture

Dr. Sunny Dole

Sir meri age 26 years hai I have shoulder pain neck pain and back pain. Sir ye problems 7 to 8 years se ho rhi h. Eske liye mai altrasound and MRI jach bhi karwaya likin sb normal hi dikha hai Dard kuchh jyada kam karne se suru ho jata hai phir kuchh Dino tk jyada tej dard rhta hai phir dhire dhire automatic thik ho jata h

Female | 26

pl get alternative therapy - Acupuncture and acupressure done you will get permanent relief without medicine without surgery. 
take care
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Dr. Hanisha Ramchandani

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