Losing Weight Prior to an Orthopedic Procedure
It’s proven that obesity and its related diseases have an adverse effect on outcomes in orthopedic surgical cases. Morbid obesity, defined as a BMI of 40 or more, is particularly worrisome. This is especially true for patients with type-2 diabetes, a disease most often caused by excess weight and obesity.
As a result, if pre-op testing comes back showing significant operative risk due to any number of obesity related diseases, most especially type-2 diabetes, patients may be placed on appropriate medications, but ultimately, losing weight prior to surgery is the best and healthiest option.
However, as we know, losing weight is not easy and many patients are not able to lose a significant amount of weight. These patients must then make a decision to change their lives or postpone their surgery. Otherwise, they take on additional risk during the procedure.
Prevention: Cutting knee pain
With rising obesity rates, the risk of knee pain due to osteoarthritis have increased as well. According to the Arthritis Foundation, losing just 15 pounds can cut knee pain in half. This is no wonder as every pound of excess weight adds four pounds of pressure to the knees. Improvement hip and spine pain can be improved as a result of weight loss. However, even if surgery is unavoidable, the risks of surgery are significantly lower in patients who maintain a normal, healthy weight.
Some interesting facts to ponder:
- Up to 97% of total knee replacements can be attributed to osteoarthritis
- Administration of anesthesia can be more difficult and riskier in obese patients
- Obese patients typically have longer hospital stays and higher complication rates including infection, blood clots and even trouble breathing
- New hardware may fail prematurely or may dislocate as a result of excess weight
- Your mental state and outlook will be improved both before and after surgery if you lose a significant amount of weight before surgery
- You don’t need to lose all your excess weight to get a benefit
While joint pain and disability pushes us to consider joint replacement early on in the process, there is ample evidence to show that losing weight can sometimes prevent or at least postpone invasive surgery. That said, even if joint replacement is unavoidable, maintaining a normal weight, or at very least losing some excess weight can make a significant difference in outcomes of surgery.