October 26, 2012
Many Complications For Obese Patients Following Knee Replacement Surgery
Obesity related to higher rates of infection and other complications following surgery
Obese patients have a greater risk of complications following total knee replacement surgery, including post-surgical infections, according to a new literature review recently published in the Journal of Bone and Joint Surgery (JBJS). Because of complications, obese patients are more likely to require follow-up surgery (revision).
“Orthopaedic operations can technically be more difficult in obese people, and it is important for us to know whether there is a higher complication rate in the obese, and if the long-term outcome is worse,” says Gino M.M.J. Kerkhoffs, MD, PhD, an orthopaedic surgeon at the Academic Medical Center Amsterdam, University of Amsterdam, and lead author of the study.
-Obese patients have double the rate of infection following total knee replacement surgery compared to non-obese patients.
-Obese patients´ rate of infection is higher for both superficial and deep infections.
-The long-term surgical revision rate for obese patients is nearly double that for non-obese patients.
The paper´s authors advise that knee replacement surgery not be withheld from obese patients. Rather, obese patients should be well-informed of the likelihood of complications following their total knee replacement, and advised to lose weight before surgery. Orthopaedic surgeons should be prepared to refer them to medical weight-loss professionals, if necessary. The authors also note that weight loss could lessen some patients´ osteoarthritis symptoms.
“Although these results are not really surprising,” Kerkhoffs says, “for the obese patient, this literature sheds new light on treatment options for symptomatic knee osteoarthritis: a total knee replacement is not the ℠easy solution.´”
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