High BMI may be non-modifiable risk factor for TJA in patients with morbid obesity

SAN DIEGO — Results presented here showed a high BMI should be considered a non-modifiable risk factor for joint replacement if a patient cannot lose weight after a 6-month to 9-month trial of weight reduction.

“Basically, giving 6 [months] to 9 months of an attempted weight loss is certainly a reasonable time period, after which it may be more important to have discussions about risks of surgery itself and treat this more as a nonmodifiable risk factor,” Stephen J. Huffaker, MD, said in his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.

Huffaker and colleagues retrospectively reviewed 44 patients with osteoarthritis (OA) and 172 patients without OA, of whom both were morbidly obese and actively enrolled in a nonoperative weight reduction program for at least 1 year. Researchers considered group differences in BMI of 5% clinically significant.
during a 1-year period.

“The other important part that we found was that about one-third of patients were able to lose a meaningful amount of weight, but only about 18% were able to successfully drop their weight below a BMI of 40 and that was the same between osteoarthritis and not,” Huffaker said.

He noted patients who were able to successfully lose weight started with a lower BMI, with almost no patients with a BMI greater than 45 able to lose weight to a BMI less than 40.

“This corresponded to about 10% of losing weight below 40 if they started with a BMI over 45,” Huffaker said. “The people who were able to lose weight did so within basically the first 6 months, again regardless of osteoarthritis vs. controls.” – by Casey Tingle

Reference:

Huffaker S, et al. Paper #136. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting. March 14-18, 2017; San Diego.

Disclosure: Huffaker reports no relevant financial disclosures.