Combatting obesity is a challenge for many patients. It becomes more important if you need total knee or total hip replacement surgery. Even though you may feel healthy at your current weight, a patient with a body mass index (BMI) greater than 40 is more likely to experience serious complications both during and after surgery than a patient of normal weight. However, you can take steps before your procedure to minimize these risks.
How to Calculate BMI
BMI is an estimate of body fat based on height and weight. Typically, the higher your BMI, the more body fat you have.
For an adult, the following BMI ranges apply:
|BMI Ranges||Weight Status|
|18 to 24||Normal|
|25 to 29||Overweight|
|30 to 39||Obese|
|40 to 49||Morbidly obese|
However, because BMI is a simple ratio of height to weight, it doesn’t always tell the full story. Patients with a lot of muscle relative to their height, for example, might have a high BMI despite low body fat. For most people, though, BMI is a useful guidepost for both the patients and their surgeons.
Risks of Surgery for Patients with Obesity
Patients with obesity are more likely to have certain health conditions that increase the risks of surgery. These include cardiovascular disease, high blood pressure, diabetes, obstructive sleep apnea and others. It is important to be in the best health possible before your surgery. If you have one of these conditions, it is important to work with your doctors to ensure that it is managed and under control before your procedure.
There are risks associated with every surgery. However, some risks are greater for patients with obesity. It is more difficult to administer anesthesia to a patient with obesity. There are technical challenges associated with performing surgery on a patient with obesity, so operative times are often longer, resulting in greater risk of complications. Compared with a patient of normal weight, a patient with obesity is more likely to experience:
- Poor wound healing
- Difficulty breathing
- Blood clots
- Pulmonary embolism—a blood clot in the lung
Weight Loss Before Joint Replacement Surgery
Joint replacement will help relieve your pain and improve your mobility. However, if you have obesity, you may never achieve the benefits experienced by a patient of normal weight. You may also experience more implant complications after surgery, including component loosening and failure, or dislocation in the case of hip replacement. In some cases, a second “revision” surgery may be necessary to correct this.
Since most total joint replacements are elective procedures, you have time time to lose weight and reduce your BMI before your procedure. The key elements to losing weight are diet and exercise. In general, you should try to reduce your fat and calorie intake and increase your low-impact activities, such as swimming, biking or using an elliptical machine.
So don’t put it off—take it off now! Losing weight and reducing your BMI will decrease your risk for complications and increase the likelihood of a successful surgical outcome. In some cases, it may also decrease your pain to the point where joint replacement can be put off for a number of years.
If you’re looking for help in deciding to have joint replacement surgery, schedule an appointment with one of our surgeons. We’ll walk you through everything you need to decide to get a joint replaced, including a weight loss plan to maximize the surgery’s chance for success. If joint replacement is not right for you, we can offer you alternatives to decrease your pain and let you live an active, healthy lifestyle.