The Impact of Obesity on Total Joint Arthroplasty

Abstract

With an increasing demand for arthroplasty in younger and heavier patient populations, surgeons should be prepared to safely treat this challenging group. Every aspect of the care of an obese patient is more challenging than that of a patient of normal weight, and the outcomes are often inferior. The risk of complications of arthroplasty increases when the body mass index (BMI) reaches 35 kg/m, and morbidly obese patients may be at substantially increased risk for complications requiring surgical intervention. Weight loss before arthroplasty should be encouraged, and patients should understand that the surgery is unlikely to result in weight reduction. Treatment options for obesity in patients who are candidates for arthroplasty include counseling, diet programs, medications, and bariatric surgery. Brief counseling and referral of these patients for appropriate treatment of their obesity can be an effective method of avoiding complications following surgery.

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