TJA in Patients With Obesity - Understanding the Scale of the Challenge

Description

In this symposium presentation led by Jason Werle, the focus is brought to the intersection of total joint arthroplasty and obesity. Werle begins with an introduction outlining his talk's intent to clarify the severity of the issues surrounding obesity in relation to joint surgery. He discusses the increasing prevalence of obesity globally, with a stark statistic indicating that 800 million people are classified as obese and predicts a further rise in childhood obesity. Canada showcases a concerning trend, with a three-fold increase in obesity rates since 1985, bringing the number to one in four Canadians living with a BMI over 30, despite being better off than the U.S. in terms of proportions.



The speaker underscores the various risk factors contributing to obesity, highlighting genetic predisposition and environmental issues, as well as the health repercussions associated with obesity, particularly its linkage to osteoarthritis of the knee. He presents data from Canada and Australia, noting that 60% of total knee arthroplasties performed in Canada involve patients classified as obese, mirroring Australian figures. It’s highlighted that patients with higher BMIs, especially those over 30, experience increased adverse events, including a higher risk of medical and mechanical complications post-surgery.



A critical study is shared involving 11,000 patients from Alberta, which correlated BMI with outcomes like pneumonia and deep infections, alongside a 2% higher rate of revisions for obese patients within two years post-surgery. The discussion reflects on the existing literature around this pressing issue, noting the trends observed in super obesity and the proposal of BMI cutoffs for elective surgeries, with emphasis on optimizing patient health before surgery as a more effective approach rather than outright exclusions.



Werle concludes by reiterating the vital need for awareness of obesity as a chronic disease that necessitates tailored management strategies to enhance arthroplasty outcomes and optimize patient health.

Specialties