Caring Medical - Where the world comes for ProlotherapyWeight management, not joint replacement. Knee replacement is not the easy way out

Weight management, not joint replacement. Knee replacement is not an easy way to weight loss.
Research: Knee replacement does not help people lose weight.

Many patients are under the assumption that the quickest way to attack their obesity problem is to get a joint replacement. The thinking is that is they eliminate their knee pain they will be able to exercise and lose weight. Surgeons are being told to tell patients that is not true for many obese patients.

Doctors at the University of Texas MD Anderson Cancer Center (1) showed that increasing BMI (Body Mass Index – Obesity) and anxiety levels and decreasing levels of positive social interactions were associated with increased patient costs (the need for continued care) following total knee replacement. The greater the obesity the greater the patient need for care (cost) following the knee replacement.

Research: It is unclear whether total knee replacement facilitates weight reduction.


One thing for sure, surgery in obese patients is more technically challenging.

Doctors in the United Kingdom reported these findings in the journal Maturitis (2)

  • There is a proven association between obesity and knee osteoarthritis, and obesity is suggested to be the main modifiable risk factor.
  • Obese patients are more likely to require total knee replacement
  • It is unclear whether total knee replacement facilitates weight reduction
  • Surgery in obese patients is more technically challenging.
    • This is reflected in the evidence, which suggests
      • higher rates of short- to medium-term complications following total knee replacement, including wound infection and medical complications, resulting in longer hospital stay, and potentially higher rates of malalignment, dislocation, and early revision.

Research: High patient weight is a risk factor for mechanical implant failure and some knee replacement manufacturers list obesity as a contraindication for implant use.

In another study from the United Kingdom, doctors were much more critical of putting implants into obese patients as they noted in the Annals of the Royal College of Surgeons of England.(3)

High patient weight is a risk factor for mechanical implant failure and some manufacturers list obesity as a contraindication for implant use. Doctors in the United Kingdom were amazed to find out that:

  • A total of 10,745 patients in a two year period 2012-2013 received knee or hip implants against manufacturer recommendations.
  • 16% of all obese patients) received implants against manufacturer recommendations.

Research: overweight patients are at a more than 40% greater risk and obese patients are at more than a 100% increased risk of knee replacement surgery compared to patients with normal weight

The simple summary to all the research listed above is this:

Doctors at Oxford University publishing in the journal Arthritis and Rheumatology (4) found that overweight patients are at a more than 40% greater risk and obese patients are at more than a  100% increased risk of knee replacement surgery compared to patients with normal weight. Weight reduction strategies could potentially reduce the need for knee replacement surgery by 31% among patients with knee osteoarthritis.

If this article has helped you understand the problems of obesity and joint pain and you would like to explore Prolotherapy as a possible remedy for your joint pain, ask for help and information from our specialists

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Danielle Steilen-Matias, PA-C | Katherine Worsnick, PA-C | Ross Hauser, MD | David Woznica, MD

Research citations:

1 Waimann CA, Fernandez-Mazarambroz RJ, Cantor SB, Lopez-Olivo MA, Barbo AG, Landon GC, Siff SJ, Lin H, Suarez-Almazor ME. Effect of Body Mass Index and Psychosocial Traits on Total Knee Replacement Costs in Patients with Osteoarthritis. The Journal of rheumatology. 2016 Aug 1;43(8):1600-6.  [Google Scholar]
2 Kulkarni K, Karssiens T, Kumar V, Pandit H. Obesity and osteoarthritis. Maturitas. 2016 Jul;89:22-8. doi: 10.1016/j.maturitas.2016.04.006. Epub 2016 Apr 11. Review. [Google Scholar]
3 Craik JD, Bircher MD, Rickman M. Hip and knee arthroplasty implants contraindicated in obesity. Ann R Coll Surg Engl. 2016 May;98(5):295-9.  [Google Scholar]
4. Leyland KM, Judge A, Javaid MK, Diez-Perez A, Carr A, Cooper C, Arden NK, Prieto-Alhambra D. Obesity and the Relative Risk of Knee Replacement Surgery in Patients With Knee Osteoarthritis: A Prospective Cohort Study. Arthritis Rheumatol. 2016 Apr;68(4):817-25. [Google Scholar]

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