Why a Healthy Weight is Important for Successful Joint Replacement

Obesity affects nearly 94 million adults in the United States. Studies show this number has more than doubled in the past 30 years. In addition to triggering a wide range of health problems, obesity goes hand-in-hand with joint pain. Ironically, many are turned down for joint replacement surgery unless they lose a prescribed amount of weight.

"I always tell patients, 'I want to help you. It is not a question of if; it is a question of when,'" says Orthopedic Specialists' adult reconstruction surgeon Dr. Christopher James. "I provide them with resources such as bariatric or a nutritionist which can help them lose weight."

People with a body mass index (BMI) of 30 or more are considered obese; those with a BMI of 40 or greater are considered morbidly obese. This matters because each pound of body weight exerts four to six pounds of pressure on each knee. People living with obesity are 17 to 20 times more likely to need a knee replacement than a person of optimal weight.

In one Australian study, 58 percent of people who underwent knee replacement for osteoarthritis were obese. Those with the highest BMI had joint replacement up to seven years earlier than those of a healthier weight.  Here in the United States, many obese people living with joint pain face a conundrum. Although joint replacement will help them become more active and lose weight, they are typically considered risky candidates for joint replacement.

Many providers and hospitals require patients to lose weight to qualify for surgery. While some large people call this discrimination, the restrictions are based on years of data. Obese joint replacement patients often face:

• Complications during and after surgery
• Higher infection rates
• Longer hospital stays
• A higher failure rate of prosthetic joints

Losing significant amounts of weight is, without a doubt, a difficult task. “There is no quick fix,” says Orthopedic Specialists' adult reconstruction surgeon, Alan J. Graves, MD. “By the time they come to me for a knee replacement consultation, they’re at a fork in the road, and that is exactly what I tell them. They can choose to continue the path they’re on, and the pain and loss of mobility will get worse, or they can choose a more difficult but healthier path.”

A study of 300 morbidly obese patients showed that only 19 percent of patients who were told they could have surgery after they lost weight actually followed through. The 2019 study indicated that many seriously overweight patients need additional support.

In addition to resources provided by our doctors, some healthcare organizations such as AdventHealth’s Bariatric and Metabolic Institute in Tampa have developed joint orthopedic-bariatric programs. Patients first undergo weight loss surgery to achieve an ideal weight for orthopedic surgery. However, such resources are in the early stages and are limited.  

For those who want to combine a diet with a traditional exercise program, Livestrong.com offers these workout tips for larger people. For more information about Orthopedic Specailists' joint replacement options, call 727-496-2391 or visit its website: www.palmharborortho.com.