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Obesity Associated With Higher Risk Of Orthopaedic Conditions

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Orthopaedic procedures can help minimise pain and improve bone and joint function in patients with obesity, researchers said this week.

While this group of patients may experience slower recovery and higher rates of surgical complications, orthopaedic interventions can still provide improvements in quality of life even for super-obese patients, according to a study published in the November issue of the Journal of the American Academy of Orthopaedic Surgeons.

The study – titled ‘Obesity, Orthopaedics, and Outcomes´ – looks at the links between obesity and orthopaedic conditions and considers the pros and cons of surgery in this patient group.

The researchers note that obesity is a strong independent risk factor for musculoskeletal pain, and almost doubles the risk of chronic pain among the elderly. Excess weight causes pain in soft-tissue structures such as tendons and ligaments, and worsens conditions such as fibromyalgia in individuals already living with constant pain in their muscles and joints.

Osteoarthritis is also frequently associated with obesity, with excess weight placing extra pressure on the knees and increasing the likelihood of wearing away the cushioning surface of the joint.

In addition to the increased likelihood of wear and tear on joints, people with excess weight are also at higher risk of sustaining musculoskeletal injuries. For those who are classed as overweight, the odds are 15% higher than people of normal weight. Among those who are obese, there is a 48% higher risk of sustaining musculoskeletal injuries, the researchers report.

Meanwhile, overweight and obese children are more likely than their normal-weight peers to experience back and lower extremity pain, especially of the knee and foot.

No upper weight limits have been established that would contra-indicate elective orthopaedic surgery, but every surgeon must understand the unique risks an obese patient faces and understand how to optimise and treat each of these patients on an individual basis, commented orthopaedic surgeon William M. Mihalko, MD, PhD, co-author of the study.

The researchers recommend that patients with morbid obesity (BMI of 40 or higher) be advised to lose weight before total joint arthroplasty, and offered resources to help them lose weight. They should also be counselled about the possible complications and inferior results that may occur if they do not lose weight.

Ultimately, even though patients who are obese are at greater risk of complications, orthopaedic procedures may still offer them notable pain relief and improved quality of life, the study authors conclude.