One of the questions we are asked most frequently by patients who are overweight is will it affect the success of their hip replacement surgery and should they try and lose weight before having their operation. The answer to both questions is yes.
There are a number of suggested ways that patients can improve their chances of positive outcomes after surgery and at the top of the list is losing weight. This is because being overweight increases the risks of serious complications from joint replacement surgery. Studies suggest that having a BMI (body mass index) of 40 and above makes the risk of complications during and after surgery more likely, compared to someone of normal weight.
Research findings presented in Osteoarthritis Cartilage in January 2020 considered 67 studies involving 581,012 obese and 1,609,812 non-obese patients who’d undergone total hip replacements. The data was examined to assess the outcomes and complications associated with total hip replacement surgery.
The study showed that obese patients had a higher risk of all types of complication. In particular, they were more likely to develop deep infections, superficial infections and dislocations. They were also more likely to need to be readmitted to hospital, to undergo a further operation or to have revision joint replacement (which is when the artificial implant has to be replaced).
Researchers also considered morbidly obese patients and found that the risks were even higher. They concluded that surgeons needed to make patients aware of these increased risks and encourage them to lose weight prior to surgery.
What is BMI?
BMI is a measure of body fat based on a person’s height and weight. In an adult a BMI of 25 to 29 is considered overweight, 30 to 39 is obese and 40 to 49 is morbidly obese.
What are the complications associated with obesity?
All surgery carries risks but for someone who is obese the risks are increased, sometimes significantly.
During surgery, for example, it might be more difficult to administer anaesthetic due to the patient’s body shape and size or problems locating veins.
Patients who are obese are also more likely to have health conditions that can affect breathing and it may be difficult to ensure sufficient airflow and oxygen during surgery. Time on the operating table may also be higher and this increases the risk of complications.
After surgery, someone with a BMI over 40 is also more likely to experience complications including infections, blood clots, pulmonary embolism and wounds being slow to heal. Carrying excess weight puts additional pressure on an artificial hip implant and increase the likelihood of it becoming loose or dislocated. Patients who are obese are more likely to need to be readmitted to hospital or undergo revision joint replacements to remove a failed implant and replace it.
What can you do to reduce your risks?
Your orthopaedic surgeon may recommend postponing your hip replacement surgery to allow you an opportunity to lose weight before your procedure, thereby reducing your risk of complications.
Making lifestyle changes such as getting more exercise and eating a healthy balanced diet will not only improve your surgical outcomes, it will also help you to feel better and make a better and more rapid recovery. Your doctor will be able to advise you if you need support with weight loss or an exercise plan. You may also be able to have non-surgical treatment to manage the symptoms if you need to postpone surgery in order to lose weight.
Talk to us if you would like advice about hip replacement surgery or reducing the risk of complications.