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Forum Tackles the Rising Costs, Challenges and Diminished Outcomes Associated with Treating Obese Patients for Orthopaedic Conditions
Date:4/11/2013

f weight gain.

Overall, when combined with inactivity, a high BMI can cut life expectancy by as much as seven years, said Dr. Losina.

The impact of obesity on health care spending also is significant, resulting in $215 billion in increased medical expenditures each year, according to a 2010 report by the Brookings Institution. By 2030, "health care costs attributed to overweight and obesity are predicted to account for 16 to 18 percent of total U.S. healthcare costs," said Dr. Kelly.

Dr. Losina explained that each additional kilogram (kg) of body mass increases the compressive load on the knee by roughly 4 kg. Therefore, even a relatively small loss in weight can have a tremendous impact. For example, a patient who loses 10 pounds in body weight will diminish the load/pressure on their knees by 50 pounds.

A high BMI is associated with more than 60 related medical conditions, including Type 2 diabetes, coronary artery disease and sleep apnea.  A high BMI also affects fasting blood glucose levels, which in turn, are associated with a higher risk of surgical site infections, said William M. Mihalko , MD, Ph.D., professor and JR Hyde Chair at the Campbell Clinic department of orthopaedics and biomedical engineering at the University of Tennessee.  Overweight and obese patients with sleep apnea who receive regional anesthesia before surgery have higher complication rates following orthopaedic surgery.

Kenneth Krackow , MD, professor and vice-chairman of the department of orthopaedics at the University of Buffalo School of Medicine, said that orthopaedic surgeons need to work with overweight patients before total joint replacement surgery to encourage weight loss – even suggesting bariatric surgery – and utilizing the joint replacement as an incentive for healthier habits.

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SOURCE American Academy of Orthopaedic Surgeons
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