Breaking Point: Orthopedics and Weight
Intellihealth interviews HSS hip and knee surgeon Michael L. Parks, MD, in a “Weight Matters” podcast episode about the link between orthopedics and weight and the correlation between obesity and arthritis.
According to Dr. Parks, “[Arthritis] is multifactorial. Some people are just going to get it, they’re outliers and get it for no reason. There are other people who may get it because it’s been inherited through their parents, their siblings, they have it, and there’s some genetic component. There’s also a mechanical component, whether people were runners or athletic in the past."
He continued, “If you’re just mildly obese — that would be a BMI over 30 — you’re about 8-10 times more at risk. But as your obesity increases, you go up to about 32 times more likely to develop arthritis and the need for a total knee replacement,” Dr. Parks explained, citing data from the Canadian Registry. “That shows to me that there is a pretty clear relationship between the magnitude of obesity, the development of arthritis, and then the progression to a need for total knee replacement.”
He explained, “30% of obese patients undergoing total knee replacements have at least three medical problems like diabetes, coronary artery disease, hyperlipidemia, hypertension, sleep apnea, compared with only 7% of non-obese patients. So they have these medical problems that we have to contend with, and they could have postoperative complications related to their medical issues that they have.”
Dr. Parks said, “I stress to the patients that they don’t have to come in and be thin, this is about them 1) being engaged, and 2) about the change, about them losing weight.”
He continued, “Generally patients will lose 5, even 10% of their body weight, and it allows us then to meet the requirements of many insurance companies, of our own hospital, and to proceed with surgical treatment.”
Dr. Parks advised that weight loss is the most important tool at someone’s disposal to decrease their risk for arthritis or slow down its progress in the early stages.
“Patients often come to me and they say, ‘I can’t lose weight because I have a bad knee or hip and I can’t exercise.’ And I like to tell them right then, that that’s not, in many cases, how you’re going to lose weight. I’ve found with the patients that I see and in my own experience, that it’s going to be dietary,” he explained.
“I also tell them, probably most importantly, to listen to their body. If they’re doing something that’s bad for their joints, it’s probably painful,” he added. “If they’re uncomfortable, they’re probably doing something they shouldn’t be doing.”
Listen to the full episode at Intellihealth.co.