Recent study from 2017 sensus estimates 32 million adults in the united states are affected by crippling destruction of the joints. In my practice 1 our of 3 patients struggel with a weight problem. Most commonly affected joints are weight bearing joints, hip and knee. Non surgical options include, therapy, crutches and weight loss. When these fail, surgical option is the only remaining treatment plan. Unfortunately, patients who have severe obesity have a higher rate of complications after replacement surgery. Some studies report 4-15% increase in joint infection alone, depending on the weight class studied. This makes the only treatment plan dangerous and potentually very costly. In efforts to protect patient from unethical surgeons, many hospital and insurance companies have established weight restrictions.
In my practice, I strive to counsel patients regarding their modifiable risk factors and try my best to reduce the risk, avoiding painful and expesive complications before they ever happen. This at times creates challenging clinical interactions, given that obesity is overall a sensitive topic to discuss. I find that in most cases kindness, honesty and proper counceling improves shared decision making and improves patient satisfaction and outcomes.
