Management of the Bariatric Patient. What Are the Implications of Obesity and Total Joint Arthroplasty: The Orthopedic Surgeon's Perspective?

BACKGROUND: Obesity in the United States has reached epidemic proportions. It is associated with multiple higher rates of osteoarthritis of the hip and knee and thus an increasing need for total hip and knee arthroplasty. The demand for total joint arthroplasty among obese patients has increased and outpaces that of a non-obese cohort. The complications associated with obese patients undergoing hip or knee replacement is well defined in the literature.
METHODS: Many practices have set restriction on body mass index (BMI) prior to elective total join arthroplasty. We review the implications of these BMI cutoffs as it is related to access to care for morbidly obese patients in need of hip and knee arthroplasty.
RESULTS: Of the 289 patients who presented with BMI >40, only 19% of patients underwent total hip or knee arthroplasty at a minimum of 2 years of follow-up.
CONCLUSION: This symposium discusses the implications of withholding surgery in the morbidly obese and sets the stage for the development of more collaborative work to ensure optimal care and optimal outcome for the morbidly obese.