According to the CDC, obesity is a serious lifestyle disease affecting more than 70 million or 41.9% of the American population. It is also the leading cause of several life-threatening illnesses, such as heart problems, diabetes, stroke, and cancer. Furthermore, obesity is a prevalent risk factor in many preventable diseases that may cause premature death.
But what a lot of people do not know, obesity also poses a huge risk for people undergoing surgical procedures, such as knee replacement surgery.
Read on below about the risks of knee replacement procedures for obese patients and what you can do to ensure a safe operation.
What is knee replacement surgery?
A knee replacement or arthroplasty refers to the surgical removal of the damaged bones and cartilages in the knee to replace them with artificial ones. An orthopedic surgeon uses metals or plastic implants to replace the thighbone, shinbone, or kneecap. Then, the artificial parts will be secured and supported using screws, plates and rods.
Generally, doctors recommend this type of procedure for patients experiencing knee pain due to worn-out knee joints and structures. Some examples of such conditions include severe or late-stage arthritis, tendonitis, muscle tears, and traumatic injuries.
What are the risks of knee surgery in obese patients?
Obesity is a risk factor for many diseases, including knee problems. When you’re overweight, the structures in the knee (knee joint, patella) are forced to carry five times the weight it was supposed to support. This can result in muscle weakness and joint damage, leading to stability and mobility problems over time.
In fact, a study suggests that obesity is the leading culprit for the increasing number of knee dislocations from 2000 to 2012. Of course, this also means an increase in care costs and complications since obesity poses a significant risk during surgical procedures. Here’s why:
Complications in anesthesia
Of course, all surgical procedures come with health risks due to anesthesia. However, obese patients have a higher chance of experiencing complications during surgery due to anesthesia. Some problems that might be encountered include:
- Determining the right type and dosage of anesthesia.
- Technical problems in administering anesthesia through the veins, spinal, or epidural nerve.
- The need for a breathing tube to ensure sufficient oxygen flow.
- Ensuring that the airflow is always free from obstruction during the surgery.
Furthermore, being obese means you might have sleep apnea, wherein your breathing can temporarily stop while you’re asleep. This can happen while you’re under anesthesia, which can be life-threatening as you can lose consciousness at any time.
Additionally, overweight patients may have other comorbidities (e.g., heart disease, stroke), which can pose complications during the surgery itself.
Longer operative times
Typically, doctors recommend knee arthroscopy to treat the early stages of knee problems. However, this minimally-invasive procedure may not be an option for overweight patients due to technical difficulties.
For example, your surgeon may experience a hard time accessing the site since the instruments may be too small or short for the patient’s size. They may also take a different or more complex approach which can prolong the operative time.
Orthopedic surgeons may also opt to perform a traditional open surgery instead of arthroscopy to increase knee accessibility. However, this may also result in a longer operative time.
Poor wound healing after surgery
Studies suggest that obesity impairs the ability of the body to heal wounds due to vascular insufficiencies. Patients with excess weight develop more adipose tissues, which increases the demand for the circulatory system to supply blood and oxygen.
Unfortunately, the capillary network does not increase in proportion to the number of fatty tissues. This leads to vascular issues and venous insufficiency, which can then result in poor wound healing because:
- There’s a decrease in blood vessel function, thus resulting in decreased oxygen and nutrients that go into the surgical wound.
- An impaired blood vessel allows intravascular fluid to leak, thus initiating an inflammatory response.
- Inflammation can destroy neighboring tissues instead of healing them. Plus, leukocytes and platelets (important cells for healing) can become trapped in the fluid, thus not reaching their target tissues.
Additionally, obese patients have an unhealthy body state due to their high fat, high calorie, and high carbohydrate diet. As a result, they lack the necessary vitamins and minerals to facilitate complete wound and body healing.
Lastly, poor wound healing leads to an increased risk of infection, which presents another life-threatening complication.
Decreased chance of a successful surgery
Normally, a knee replacement surgery has a 90% success rate and can last for over ten years. However, for patients with obesity, there’s an increased chance that the surgery won’t relieve your knee pain nor bring back its normal function due to excess pressure still present on the knees.
There’s also an increased likelihood of artificial implant impairment (e.g., misalignment, loosening) due to the excess weight present.
Should obese patients still consider knee replacement surgery?
It’s important to consider the surgical complications that may come with every procedure. However, these should not hinder a patient or doctors from recommending knee replacement surgery to relieve their conditions’ debilitating symptoms.
Studies suggest that obese patients experience more pain and movement difficulties before knee surgery. Additionally, there may be a decreased chance of a long-lasting success rate for obese patients. But research suggests that there’s still substantial functional gain for patients who have undergone surgery compared to patients who don’t.
The best course of action for obese patients with knee problems is to search for the best orthopedic doctors.
If you have been experienced knee problems and happen to live in the Spring Hill area, visit our leading orthopedic doctor in Brooksville, FL. Our experienced orthopedic physician can help create the best treatment plant to address your medical needs.
Where to find the best knee replacement in Spring Hill?
Dr Imad Tarabishy is a board-certified orthopedic surgeon that specializes in providing orthoepdic care, such as knee replacement surgery in the Spring Hill area. He has provided excellent patient care and high-quality treatment services to various patients for over 30 years.
Some of the many services we offer at Tarabishy Orthopedics include:
- Knee arthroscopy
- Shoulder arthroscopy
- Hip replacement
- Carpal tunnel release
- Trigger finger release
- Meniscus tear treatment
- Iovera treatment
- Mako robotic surgery
Ensure a safe and successful knee surgery by partnering with the best orthopedic doctor. Contact us now so we can start planning your treatment process!
The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.