Dr. Pradeep Sharma
Director & Head
BLK Centre for Orthopaedics,
Joint Reconstruction
& Spine Surgery
BLK Super Speciality
Hospital, New Delhi

The results of Knee Arthroplasty in grossly obese patients have varying degrees of success. Occasionally, patients with BMI of more than 40 are seen in Orthopaedics clinics with severe Osteoarthritis demanding early knee surgery. Their demand is often compelling and they would not heed to weight loss management prior to surgery.

Obese patients have to deal with high stress level activity and their knees fail early under heavy loading conditions. Such knees are more prone to develop complications as compared to that of a patient with BMI of 30 or less. Obese patients usually have to face gross deformities over the years. Relatively Hypoplastic, Osteoporotic bones are generally accompanied with many co-morbid conditions like Hypertension, Diabetes, Hypothyroidism, etc. Their pain scores are high and walking abilities are seriously affected. Many would shun the idea of getting Bariatric surgery done prior to knee surgery. The knee pain is so agonising that they want instant relief from the pain, hoping for improved quality of life.

Under such circumstances it becomes extremely challenging to perform a successful TKR on an obese patient owing to many disadvantages like increased incidences of prosthetic loosening, deep knee sepsis, non-healing wounds & discharges due to fat emulsification. There are also increased technical complications in obese knees, like ligamentous laxity, inaccurate bone cuts, soft tissue damage, poor positioning of implant, etc. Due to such complexities TKR is seven times less successful in obese patients than normal ones with low BMI.

However, the relief of pain, renewed energy to walk and improved quality of life after Total Knee Replacement lures many patient to accept the procedure despite the odds. The concerted efforts of the team at BLK and advanced technology has enhanced the success rate of TKR even in obese patients, resulting in an active life for them with improved mobility and overall well-being.