Health
Joint replacement in extremely obese possible, but complicated
NEWS IN BRIEF — Posted March 2, 2009
Artificial hips and knees can be implanted in patients with a body mass index greater than 50, but the adverse event rate is excessive, according to a pair of studies presented Feb. 26 at the annual meeting of the American Academy of Orthopaedic Surgeons in Las Vegas.
Researchers from the Mayo Clinic in Rochester, Minn., analyzed data on 41 hip- and 105 knee-replacement patients who were obese. Subjects were followed for an average of three years. Nearly 40% of those who had hip replacements experienced a surgical complication such as prolonged wound drainage or residual sciatic neuropathy. Slightly more than 12% had a major problem, such as requiring multiple surgeries, or experiencing recurrent dislocation or frequent infections.
The knee-replacement group had a surgical complication rate of nearly 41% and an adverse-event rate of 14.3%. Two patients died in the perioperative period.
The authors are calling for severely obese patients to be counseled about the risks of surgery and encouraged to lose weight. Referral to a bariatric physician also is appropriate.
Note: This item originally appeared at http://www.ama-assn.org/amednews/2009/03/02/hlbf0302.htm.
