If total joint replacement is on your list for the new year, making sure your body is prepared for the surgery may be the first item on your 2020 resolution list. Undergoing any kind of surgery can have its risks, and total knee or total hip replacement is no exception. In patients with obesity, these risks are even higher. Anesthesia can become difficult to administer, operative times increase, and patients see lesser outcomes, which is why your doctor may recommend losing weight before your surgery.

Complications before and after surgery have been shown to increase in patients with a BMI (body mass index) greater than 40. Often patients have the best intentions to lose weight after surgery because they assume they will be more physically active. However, studies have shown that outcomes are more favorable for patients who undergo surgery at a healthy weight. Taking the necessary steps before surgery to minimize your risks will give you the greatest chance at a successful surgery so that you can get back to doing the things you love sooner!

Health Conditions

Obesity can cause a number of health conditions which can greatly increase the risk of surgery. These conditions include:

  • Cardiovascular disease, including high blood pressure
  • Type 2 diabetes
  • Obstructive sleep apnea
  • Metabolic syndrome – a group of health conditions that increase your risk for developing cardiovascular disease and type 2 diabetes

Complications

Obesity can also cause certain complications both during and after surgery.

Complications that may arise during surgery:

  • Difficulty administering anesthesia. Challenges for the anesthesiologist may include:
    • Locating veins to administer general anesthesia and necessary medications
    • Ensuring that oxygen and airflow are sufficient
    • Properly positioning the needle when delivering spinal and epidural nerve blocks and other types of regional anesthesia
  • Increased operative times. Because of the technical challenges associated with performing surgery on a patient with obesity, operative time increases. The longer a surgery, the greater risk of experiencing complications.

Complications that may arise after surgery

  • Infection
  • Poor wound healing
  • Difficulty breathing
  • Blood clots
  • Pulmonary embolism – a blood clot in the lungs
  • Implant and prosthesis complications
    • Component loosening and failure
    • Dislocation of the replacement joint, especially in the hip

Joint replacement can make all the difference if you are looking to live a more active, pain-free life. However, obesity can keep you from achieving the increased mobility and range of motion typically experienced by a patient of healthy weight. If joint replacement is something you’re looking forward to in the near future, talking with your primary care doctor and making a change now will decrease the risk of complications and increase the likelihood of a successful surgical outcome.