obesity and hip replacements

Shocking figures illustrating the impact that the UK’s obesity crisis is having on the NHS were recently disclosed by an investigation carried out by the Sunday Times. The paper revealed that more than 41,000 obese people required hip or knee replacement operations last year – including seven teenagers.

The investigation found that the numbers of obese patients requiring joint replacement surgery had increased from 6,191 in the period 2009 to 2010 to a staggering 41, 671 in 2017 to 2018. This surge – amounting to a 575% increase – costs the NHS £200 million a year. It was found that obesity was the main or second most important factor for 25,577 of patients last year undergoing a joint replacement surgery. Another 16,184 patients had obesity as a primary or secondary diagnosis.

Obesity and arthritis

Osteoarthritis is the result of wear and tear on our joints and, simply put, any excess weight adds more stress on our joints. Therefore, a common health condition relating to obesity is the development of arthritis.
Joint replacement surgery can be a highly effective way to relieve the symptoms of arthritis; joint pain and lack of mobility but, at the same time, obesity can raise the risk of complications relating to joint replacement surgery.

Obesity and hip replacements – the possible complications

A recent study carried out by the Mayo Clinic in the US concentrated on joint surgery-related complications and their relation to BMI or body mass index. Looking at data relating to 21,000 joint replacement procedures, they focused on revision surgery, whether that’s due to problems with the original implant, early dislocation or joint infection.

The researchers found that the risk of revision surgery increased in almost a linear fashion along with the patient’s BMI – each additional pound over the optimal weight for your height increased the risk of revision surgery.

Outcome for obese patients

Interestingly, a study carried out in 2017 by the University of Massachusetts Medical School in the US found that obese patients who underwent knee or hip replacement surgery reported virtually the same pain relief and improved function as normal weight patients after six months.

The large scale study, published in the Journal of Bone and Joint Surgery, found that while obesity can increase the risk of complications associated with surgery, it shouldn’t necessarily be a deterrent when contemplating joint replacement surgery to relieve the symptoms of joint wear and tear. Function and pain were evaluated in over 5,000 patients, categorised as normal weight, overweight, obese, severely obese and morbidly obese. The more obese the patient, the worse pain and function were prior to surgery, yet after surgery, the pain scores were similar across all BMI levels.

So, some good news for those patients who are overweight and struggling with joint pain and lack of mobility to commit to an exercise regime. However, trying hard to lose weight in advance of surgery should always be the preferred option as this is likely to make surgery safer. In addition, of course, there is also a link between obesity and a whole host of health concerns, including diabetes, high blood pressure, heart disease and cancer, as well as the development of osteoarthritis.