Obesity is undoubtedly one of the biggest epidemics sweeping the United States today. The Centers for Disease Control and Prevention reported that “as of 2016 the prevalence of obesity was 39.8% and affected about 93.3 million US adults.”1 There is often an important connection between morbid obesity and osteoarthritis which frequently leads to the need for total knee arthroplasty. According to the Arthritis Foundation “Being overweight puts additional pressure on hips and knees. Many years of carrying extra pounds can cause the cartilage that cushions joints to break down faster. Research has shown there is a link between being overweight and having an increased risk of osteoarthritis in the hands. These studies suggest that excess fat tissue produces inflammatory chemicals that can damage the joints.”2 Encouraging weight loss before a total knee surgery has been found to be beneficial for patients during their recovery.
Important research has found that weight loss in morbidly obese patients before the surgery improves outcomes. Orthopedic Design & Technology notes that “Morbidly obese patients who lost at least 20 pounds prior to a total knee arthroplasty had shorter hospital stays and lower odds of having to go to a nursing facility even if they remained morbidly or severely obese, according to a study presented at the 2019 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).”3 Understanding how weight is connected with recovery after total knee surgery is beneficial to healthcare providers who can then adjust pre and post-operative planning to improve recovery outcomes.
Dr.Kenney conducted the study, “How Much Preoperative Weight Do Morbidly Obese Patients Undergoing Total Knee Arthroplasty Need to Lose to Meaningfully Improve Outcomes,” to find how much weight loss was necessary to improve operative time, length of stay, discharge to a facility and physical function improvement. The results found that morbidly obese patients who lost 20 pounds before their total knee arthroplasty resulted in a shorter length of stay and lower odds of facility discharge. The results are important because “length of stay and facility discharge are primary drivers of cost, quality of life, and satisfaction, this has immense implications,” said Dr. Keeney. “If you lose at least 20 pounds before surgery, your outcomes are going to be much better, even if you are still a physically large patient at the time of surgery. This is a concrete goal instead of telling patients we won’t operate on you unless you get below a BMI of 40, which for some patients, can be 50 or 100 pounds.”3 The study gives healthcare providers and patients a reasonable benchmark to aim for in order to help improve the outcome after a total knee replacement surgery.
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- Adult Obesity Facts | Overweight & Obesity | CDC. Retrieved July 16, 2019, from https://www.cdc.gov/obesity/data/adult.html
- Osteoarthritis Causes. Retrieved July 16, 2019, from https://www.arthritis.org/about-arthritis/types/osteoarthritis/causes.php
- AAOS News: Weight Loss Before Knee Surgery Improves Outcomes for Morbidly Obese Patients. Retrieved July 16, 2019, from https://www.odtmag.com/contents/view_breaking-news/2019-03-15/aaos-news-weight-loss-before-knee-surgery-improves-outcomes-for-morbidly-obese-patients/