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The Risks of Knee Replacement for Obese Patients

Foothills Region / 09 Nov 2023

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by EmergeOrtho
The Risks of Knee Replacement for Obese Patients

There are risks associated with a knee replacement at 400 pounds or even at 300 pounds or less. However, being overweight or obese is not automatically a disqualification for knee replacement. It is important to understand the risks and talk to your surgeon about your concerns and what you can do to minimize risks.

Is There a Maximum Weight or BMI for Knee Replacement?

There is no official weight limit or maximum BMI for knee replacement surgery. Determining who is a candidate for surgery is more complicated than a single measurement. Surgeons evaluate each patient as an individual to determine if the benefits of the surgery are greater than the risks.

Carrying extra weight can present some risks for patients undergoing a knee replacement. These are among the many factors your surgeon will consider when deciding if you are a good candidate for the procedure. Other factors include your current pain and disability levels.

The Risks of Knee Replacement if You Are Obese

Although your weight does not automatically disqualify you from knee replacement, it is an important consideration. Excess weight increases your risk of serious complications during and after surgery.

These are some of the potential complications and issues to discuss with your surgeon if you are obese and are considering knee replacement surgery:

  • Obese patients are more likely to need to stay overnight after surgery. A higher number of obese patients stay longer in the hospital or go to a rehabilitation facility instead of home after surgery as compared to nonobese patients.
  • Patients who are obese are more likely to have general surgical complications, including infections and slow-healing wounds. These lead to higher rates of readmission.
  • Obesity is often comorbid with other conditions, like diabetes or obstructive sleep apnea. These further increase the risk of surgical complications.
  • Joint placement can be more challenging in obese patients who have greater soft tissue depth at the knee. This can increase the risk of later complications with the joint.

Should I Avoid Knee Replacement if I Am Obese?

Despite the added risks, the most recent research indicates that being obese is not necessarily a reason to avoid joint-replacement procedures. A study from 2017 looked at more than 5,000 patients who had undergone knee or hip replacement surgery.

The most obese patients in the study (25% of the total) had significant improvements in function after the surgery. Their functional gains were similar to nonobese patients. The obese patients had even greater reductions in pain post-surgery.

The researchers concluded that weight alone should not be a disqualification for surgery. They still emphasized that patients and surgeons must consider the risks on an individual basis.

An even larger study from the U.K. evaluated knee replacement results in nearly 500,000 patients worldwide. These researchers found that outcomes were similar for both obese and nonobese patients. Few patients at any weight needed repeat surgery within 10 years. All groups had improved knee function and less pain.

Safe Weight Loss Before Surgery: Reducing the Risks

Weight alone is not a disqualifying factor for knee replacement, but obesity still carries risks. Losing weight before the procedure can help you reduce them. Talk to your surgeon about how much weight would be healthy to lose.

Safe and healthy weight loss is challenging for many people but worth trying for overall health and to reduce surgical risks. Options include lifestyle changes, such as exercising more and changing your diet. Your doctor might also recommend weight loss medications or bariatric surgery. Talk to your surgeon and primary care doctor for guidance on safe weight loss.

Another option available to EmergeOrtho patients is Prescribe FIT. It is a customizable, guided tool for weight loss that relies on gradual healthy lifestyle changes. A dedicated Care Coach works with patients to provide personal support throughout the process.

You can also reduce your surgery risks by improving your overall health. If you have chronic conditions, such as high blood pressure or diabetes, work with your doctor to manage them safely. Consider healthy lifestyle changes regardless of weight-loss efforts: quit smoking, reduce alcohol consumption, increase physical activity, and eat a healthy diet.

If you have knee pain significant enough to limit your mobility and impact your daily life, it might be time to consider knee joint replacement. Regardless of your current weight, it is worth discussing with an orthopedic surgeon. Contact us today to request an appointment with one of our EmergeOrtho—Foothills Region knee replacement specialists.

A New Level Of Orthopedic Care Has Emerged

EmergeOrtho-Foothills Region patients benefit from a full range of orthopedic services, including diagnostics, imaging, treatment, physical and occupational therapy, and pain management. From conservative care to surgical interventions, our team of specialists provides expert care and real results. Call (828) 672-1299 or click below to schedule your appointment today.