Obesity and joint replacement

Abstract

There has been considerable discussion as to the influence of obesity on the indications for, and the outcome after, joint replacement. Attempts have been made to withhold funding for such procedures in those who are overweight. What is the justification for this? This editorial examines the current evidence concerning the influence of obesity on joint replacement and suggests that it is only in the morbidly obese, with a body mass index > 40 kg/m(2), that significant contraindications to operation are present.

The influence of body mass index on life quality and clinical improvement after total hip arthroplasty

“…Namba et al [5] noted a 4.2 times higher risk of infection for obese patients with THA. Horan [14] even presented the gender differences in infection rates in obese patients, which only increased significantly in obese women, not in obese men. Our findings differed from previous studies in that none of our patients developed an infection following THA, which was believed to be owing to the strictly aseptic operations, proper use of antibiotics, and reasonable perioperative management.…”

“…Previous studies suggested that female gender, high BMI, and old age independently and significantly impact the outcomes of THA [14]. In order to eliminate the influence of age and gender, we designed a case-matched study retrospectively on the prospectively collected data with a gender rate of 1:1 and a rate among age groups of 4:13:10:6:5.…”

Obesity is a Major Risk Factor for Prosthetic Infection after Primary Hip Arthroplasty

“…Of the few existing reports in the current literature, there is argument for and against a correlation between obesity and the incidence of infection [16,28,29,33]. In a recent study of considerable size, an initial association between BMI and infection after THA was reported.…”

High Body Mass Index and its Effect on Total Knee Replacement

“…Prospective evidence that obesity is a significant causal factor in the initiation of knee OA has been provided by the Framingham Study [6]. It has been proved that this increase is weight-related.…”

“…Based on changing population demographics of age, sex, BMI; in the year 2035, about 1,219,362 TKRs will be carried out [4]. Given the prevalence of obesity, a significant percentage of these cases will be in patients outside the normal BMI range [5,6].…”