Optimizing TKR Patient: Weigh In On Weight!

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Optimizing TKR Patient: Weigh In On Weight!

As a complex case manager for the State Insurance Fund of the state of Idaho, I have seen over the last 7 years the body mass index (BMI) creep up for knee patients with many cases now hitting 40’s or 50’s!

Recently, Ryan Martin, et al. reviewed the literature about morbid obesity and total knee arthroplasty (J Am Acad Orthop Surg. 2017;25(3):188-194). The authors point to numerous studies which have demonstrated increased adverse outcomes after TKA in the obese population and state that, in some centers, patients whose BMI exceeds a set limit (i.e., >35 kg/m2) are required to lose weight before qualifying for TKA. However, information is limited on long-term outcomes in subjects with morbid obesity and advanced knee arthritis who do not undergo a TKA. For this reason, they believe it is difficult to determine if a weight limit should be enforced when evaluating candidacy for TKA.

Through the doctor-patient relationship we can discuss this sensitive and epidemic problem in a meaningful way. Sometimes that discussion has to include the family and friends for patients to enter successful weight loss programs. The National Institutes of Health has an easy-to-use calculator to determine the BMI for all patients.

Paul Collins, MD
[email protected]


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