Conventional wisdom says that obese people should probably put off their joint replacement surgery until they can lose enough weight to avoid any complications that may occur during an operation. The logic seems reasonable enough, but it presents something of a catch-22 for the patient: how can I lose weight if I can’t exercise? After all, obesity is closely linked with arthritis and the joint pain associated with it. Joint pain leads to inactivity, leading to weight gain, leading to more joint pain. A truly vicious cycle.
Considering a Knee Replacement Operation? Here’s What You Need to Know
How Does Joint Replacement Work?
A joint replacement is a procedure in which parts of a joint are taken out and replaced with a plastic, metal, or ceramic piece designed to mimic the movement and function of a healthy joint; this device is called a prothesis. Hip and knee replacements are the most common procedures. Though effective, joint replacement surgery is often considered the last line of treatment, which can leave the patient feeling hopeless especially when his/her surgeon recommends losing an intimidating amount of weight before surgery.
New Findings
Well, there may be good news. A 2017 study published in The Journal of Bone and Joint Surgery challenged the conventional wisdom and concluded that it may need revision. The authors found that obese people had more pain and poorer joint functionality prior to the surgery than the leaner patients, but the joint functionality gained after the surgery was significant. Additionally, the pain relief was greater for the obese patients than for those who were thinner to the point where the levels of pain were similar across weight groups. This led the authors to conclude that obesity should not stop someone from having a joint replacement operation done to relieve the pain and that having an operation done would aid the patient in living a healthier and happier lifestyle.
Losing weight prior to a joint replacement operation may not be as critical as it seems.
Of the findings, the lead author Dr. Wenjun Li said, “This surprised us a little bit. Past analysis showed that obesity is associated with outcomes to some degree, but here we see the magnitude is so small it won’t make much difference, and severely obese patients can benefit a lot from the surgery… Patients who can lose weight should, but we acknowledge many people can’t, or it will take a long time during which their joints will worsen. If they can get the surgery earlier, once function is restored they can better address obesity.”
This research is not conclusive—it will need to be studied further—and it does not negate the risks associated with the surgery itself, but it does suggest that joint replacement surgery may be a more viable option for obese people with severe arthritis.
