It’s not uncommon for people with knee joint pain from osteoarthritis to be overweight. Yet knee replacement surgery in obese patients presents many challenges, according to James Ryan, MD, a board-certified orthopedic surgeon specializing in total joint replacement surgery at Samaritan Orthopaedics and Sports Medicine Center in Corvallis.
"If you’re in constant pain, the last thing you want to do is walk, jog or work out, so it’s easy to put on extra weight,” Dr. Ryan says. “But, unfortunately, numerous studies show that obesity complicates both the recovery and long-term success of knee replacement surgery. Though many of my patients don’t want to wait for surgery, I have found it’s best to lose weight before the surgery if at all possible.”
Dr. Ryan suggests that patients with a body mass index (BMI) greater than 40 postpone surgery until after undergoing a weight loss program under the direction of a primary care provider. Those patients who have unsuccessfully tried weight loss regimens and have other problems such as diabetes, hypertension, sleep apnea or high cholesterol might visit a bariatric surgeon and discuss weight-loss options.
According to Dr. Ryan, it is important for obese patients with knee arthritis to set realistic expectations before undergoing joint replacement surgery. For example:
- The surgery will not change a patient’s weight. Studies show that obese patients will continue to gain weight after surgery unless they make lifestyle changes.
- Surgery will improve pain but will not remove all discomfort, especially getting out of chairs, climbing stairs and during other daily activities.
- Patients with diabetes must carefully manage their blood sugar during the perioperative period to avoid an infection and should watch for local wound complications and blood clots.
- Obesity may decrease the life span of knee implants on young patients, warranting future surgeries.
Dr. Ryan, who received a medical degree from the University of Southern California Keck School of Medicine, is a board-certified orthopedic surgeon specializing in total joint replacement surgery. His areas of interest and expertise include primary and revision total hip and knee replacement, partial knee replacements, hip fractures and minimally-invasive solutions to hip and knee replacements. In many cases, he uses patient-specific customized surgical instruments for total knee replacements and computerized surgical navigation for total hip replacements. He sees patients at the Samaritan Orthopaedics and Sports Medicine Center at 3620 NW Samaritan Drive, Suite 202, in Corvallis and may be reached at 541-768-4810.
For more information about joint replacement, visit samhealth.org/Ortho to request an informational packet.