Maintaining a healthy weight is good for all of us, it’s hard to argue with that. But if you’re experiencing hip or knee pain or scheduled to have a hip or knee replacement, there are very particular reasons to lose any excess pounds.
In this article we’ll look at the impact of excess weight on weight-bearing joints like hips and knees and explain how losing even a few pounds could make a difference to your mobility and to the outcomes of joint replacement surgery.
The impact of excess weight on hips and knees
The joints in your legs support your entire body weight as you walk, stand and move around, Because of the way the anatomy works the joint surfaces of the hips and knees are subjected to forces up to seven times your body weight. It’s easy to see how even a small amount of excess weight can add up to a lot of extra stress on these joints.
How is excess weight measured?
Body mass index compares a person’s weight to their height, but does not indicate percentage of body fat, muscle mass or predict health problems. Normal weight is categorised as a BMI between 18.5 and 24.9. A person who is overweight has a BMI of 25 to 29.9. Above this, there are three levels of obesity – Class 1 (30 to 34.9), Class II (35 to 39.9) and Class III (40 and above). As your BMI rises – whether the excess weight is due to fat or muscle – so, too, does your risk for surgery. A person with a normal BMI (body mass index) is far less likely to require hip or knee replacement surgery than someone with an increased BMI.
Does a higher BMI increase the risk of complications post-surgery?
Obesity can increase your risk of complications, such as infections or poor wound healing, after joint replacement surgery. If you are obese, you are also more likely to have more than one health condition (referred to as medical comorbidities). Common comorbidities include diabetes, cardiovascular disease and obstructive sleep apnoea. Having comorbidities also increases the chances of developing complications after surgery. For these reasons, it’s important to try and optimise your BMI prior to surgery. In some cases, hospitals and insurance companies may operate a cut-off point, which means that people with a BMI over 35 may be refused joint replacement surgery.
How does excess weight affect surgical outcomes following a hip or knee replacement?
The outcomes of hip or knee replacement surgery – how quickly and how well you recover – can also be impacted by your BMI. Studies show that patients who are obese tend to stay in hospital longer after surgery than those with a normal BMI. They are also more likely to be readmitted for further treatment after surgery. Obese patients who have outpatient or daycase surgery are more likely to need to be admitted to hospital for additional care and monitoring.
Managing excess weight with hip and knee problems
If you are experiencing hip and knee problems, it’s important to take proactive steps to achieve and maintain a healthy weight. These include reducing your calorie intake, increasing the amount of exercise you are taking (with the support of a medical expert), or taking weight loss medication supervised by a healthcare provider. It should be noted that weight loss drugs including GLP-1 and GIP Agonists (e.g. Ozempic, Wegovy, Mounjaro) need to be considered prior to any surgery and use of these drugs should be discussed with your orthopaedic surgeon.
Carrothers Orthopaedics adhere to the current anasesthetic
Talk to your doctor about any support that may be available to you. You may benefit from other lifestyle changes too, such as quitting smoking, improving your heart and lung function and ensuring you are getting the right nutritional balance in your diet. Improving your overall health will help you to manage your arthritis symptoms as well as increasing the chances of successful surgery.
If you have a high BMI and are considering a hip or knee replacement, it’s important to talk to your orthopaedic surgeon about the potential risk of complications.
Many, including Andrew Carrothers, offer prehabilitation which focuses on helping you achieve optimum health before surgery to increase your chances of making a good recovery. Contact us for more information and advice.
Talk to an orthopaedic consultant | Cambridge
We are always happy to provide information and guidance about the various treatment options, both surgical and non-surgical, including Mako Robotic Arm Assisted Surgery and conventional surgery.
For more information, please contact us.
Our consultation fees are clearly presented here.
For your convenience, we offer appointments at both Nuffield Hospital Cambridge and Spire Cambridge Lea Hospital.
