Obesity Heightens Knee Replacement Risk

The headline read “Knee Replacement not an easy solution for obese patients.” Alas, obese patients have double the rate of infection following knee replacement surgery (compared to non-obese patients) and the rate of infections is higher for both superficial and deep infections. Inevitably, the long-term revision rate for obese patients is nearly double that of the non-obese, according to a study published in the Journal of Bone and Joint Surgery that was conducted by Gino M.M.J. Kerkhoffs, M.D., Ph.D., an orthopedic surgeon at the Academic Medical Center Amsterdam, University of Amsterdam.

Kerkoffs said,

Orthopaedic operations can technically be more difficult in obese people, and it is important for us to know whether there is a higher complication rate in the obese, and if the long-term outcome is worse.

He notes that obesity is reaching epidemic proportions, particularly in the United States, and is a well-documented risk factor for the development of osteoarthritis. While arthritis is initially treated non-surgically, total joint replacement often becomes necessary if the disease progresses.

The paper’s authors do not suggest that knee replacement surgery be withheld from obese patients. Instead they recommend that obese patients be well-informed of the likelihood of complications following their total knee replacement, and advised to lose weight before the surgery. Orthopedic surgeons should be prepared to refer them to medical weight-loss professionals, they said. “For the obese patient, this literature sheds new light on treatment options for symptomatic knee osteoarthritis. A total knee replacement is not the easy solution.”