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Home/Large Joints and Extremities/UK Faces Obesity Epidemic
Large Joints and Extremities

UK Faces Obesity Epidemic

September 23, 2015 1 min read Premium comments

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UK Faces Obesity Epidemic
Obesity Graph / Source: Wikimedia Commons and Bibi Saint-Pol
Secondary

The number of joint replacement surgeries carried out annually on obese patients in the United Kingdom has increased four-fold since 2009, according to a report in the Irish Daily Mail. Since 2009, the number of joint-replacement operations performed annually on patients classified as obese has risen by more than 18, 000.

Hip replacements alone now cost the National Health Service (NHS) about one billion pounds a year, according to the Mail writer. Health officials point to these figures as evidence that the country’s obesity crisis is out of control.

Each knee replacement costs the NHS an average of £6, 500 pounds while hip replacements cost about £9, 000 pounds each. (An English pound is equivalent to $1.55 U.S.)

Over the past six years, the total number of knee replacements carried out annually in English NHS hospitals has risen from 76, 071 to 91, 436 which is a 20% increase. During that time, the number of knee replacements carried out on those classified as obese grew at a much faster rate—from 3, 787 in 2009/10 to 15, 188 in 2014/15.

The total number of hip replacements has increased from 94, 913 to 113, 000. Of the total, the number of hip replacements carried out on obese patients also shot up, from 2, 404 to 9, 539, according to the Health and Social Care Information Centre.

Britain is now one of the fattest countries in Europe. A quarter of the adult population is now obese, having a body mass index (BMI)—a ratio of weight to height—of 30 or more.

While the proportion of adults classed as obese appears to have leveled off in the past few years, Tam Fry of the National Obesity Forum said this disguised the increase in the “morbidly obese”—those who have a BMI of 35 or higher.

Fry said: “Obese people are getting even more obese, and people’s bodies are now buckling under their sheer weight. NHS chief executive Simon Stevens is absolutely correct when he says that the cost of obesity could well bring down the NHS.”

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Discussion

14
DS
Dr. Sarah MitchellOrthopedic Surgeon · Mayo Clinic

This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?

8
JT
James Thornton, MDSpine Fellow · HSS

Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.

5
RP
R. PatelSports Medicine · Stanford

We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.

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