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Study finds obese patients don’t need to lose weight before total joint replacement

There’s good news from UMass Medical School for overweight people with painfully arthritic hips and knees: A new study finds that obese patients who underwent knee or hip replacement surgery reported virtually the same pain relief and improved function as normal-weight joint replacement patients six months after surgery.

“Our data shows it’s not necessary to ask patients to lose weight prior to surgery,” said Wenjun Li, PhD, associate professor of medicine and lead author on the study. “It’s challenging for a patient who is severely overweight and suffering in pain to exercise – often they just can’t do it. Our evidence showed that severe morbidly obese patients can benefit almost equally as normal weight patients in pain relief and gains in physical function.”

The aim of the study, published in the Journal of Bone and Joint Surgery, was to evaluate the extent of pain relief and functional improvement in total joint replacement patients with various levels of obesity. The researchers concluded that while obesity is associated with a greater risk of early complications, obesity in itself should not be a deterrent to undergoing total joint replacement to relieve symptoms.

Prior research has documented that obesity is associated with a small, but increased likelihood of infection after total knee replacement, which may discourage obese patients from having surgery. “However, in this paper we report that obese patients have comparable pain relief and functional outcomes after surgery,” said Patricia Franklin, MD, MBA, MPH, professor of orthopedics & physical rehabilitation. “Patients should know that these benefits may outweigh risks.”

Dr. Franklin is principal investigator of the Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement (FORCE-TJR) program from the federal Agency for Healthcare Research and Quality. She co-authored the paper with David Ayers, MD, the Arthur M. Pappas, MD, Chair in Orthopedics and chair and professor of orthopedics & physical rehabilitation; Jeroan J. Allison, MD, MS,, vice chair and professor of quantitative health sciences; and colleagues at Hartford Hospital and Geisinger Health Center.