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Obesity: A Musculoskeletal Nightmare

Several new studies show higher joint replacement complication rates, longer hospital stays for obese patients

LAS VEGAS, Feb. 25 /PRNewswire-USNewswire/ -- The prevalence of obesity is rising at alarming speeds across the United States. Those living with this life-altering condition may be putting their long-term musculoskeletal function in jeopardy, according to findings released today at the 2009 Annual Meeting of the American Academy of Orthopaedic Surgeons (

National estimates show about 33 to 35 percent of men and women are obese. Defined as a body mass index (BMI) greater than 30, obesity puts a lot of unnecessary force on bones and joints, making the obese at risk for osteoarthritis ( and total joint replacement (

"As an orthopaedic surgeon practicing in a state where the obesity rate is 30 percent of its population," explained George Russell, MD, orthopaedic trauma surgeon, University of Mississippi Medical Center, "I first handedly have seen the challenges that arise when operating on obese patients."

In two similar studies, each by orthopaedic resident David J. Polga, MD, Mayo Clinic in Rochester, Minnesota, 133 patients undergoing total hip or knee replacements were assessed. Both studies concluded that total hip and knee replacements are feasible for the superobese (in this study, a BMI greater than 50), however, are associated with a high complication rate and encourage addressing the obesity prior to undertaking the elective joint replacement surgery.

Total Hip Arthroplasty (THA) in the Superobese (256)


Total Knee Arthroplasty (TKA) in the Superobese (280)


Christian P. Christensen, MD, Head of the Section of Joint Replacement at the Lexington Clinic in Lexington, Kentucky set out to compare operative times and length of hospital stays in patients undergoing total knee replacements with a BMI less than 30 (non-obese) to those with a BMI more than 40 (obese). His results show that obese patients require longer hospital stays than the non-obese, resulting in more demand on the healthcare system and higher medical costs.

Morbidly Obese TKA Patients and Longer Hospital Stay (P155)


Morbidly Obese TKA Patients and Satisfaction (P156)


According to Russell, many of these new study findings arm heavier patients undergoing joint replacement with information on what can be expected during the pre-operative and post-operative process.

In another new study, Michael Iossi, MD, resident orthopaedic surgeon, Wright State University at Miami Valley Hospital in Dayton, Ohio, studied 50 women aged 20-74 that were enrolled for gastric bypass surgery and tracked their musculoskeletal and physical changes using the Timed-Get-Up-and-Go (TGUG) and SF-36 score system, post-operatively. Overall, patients had significant weight loss and improved musculoskeletal function after the gastric bypass surgery. Mean TGUG scores improved by 2.4 seconds. Bariatric surgery (081) (

Note: This topic will be the focus of a Media Briefing entitled: "Obesity: A Musculoskeletal Nightmare" on Wednesday, February 25, in the Sands Expo Center, Venetian Hotel, Level One, Room 904 at 9:00 AM. Panelists include: Moderator: George Russell, MD; David Polga, MD; Christian P. Christensen, MD and Richard Laughlin, MD

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SOURCE American Academy of Orthopaedic Surgeons
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