BMI is independently associated with increased risk of postoperative complications after THA and TKA, says Dr. Bedard. He also indicates obesity usually does not occur in a vacuum, without other health consequences. In fact, it can be a marker of poor overall wellness: Individuals who have a 40-plus BMI tend to be overall less healthy, and often have other medical problems that can increase their risk of complications.
Potential risks and challenges for performing a TKA or THA for a patient with morbid obesity include:
· Soft tissue depth, which makes implant positioning more difficult for the surgeon
· Increased risk of wound complications
· Elevated infection risk
· Increased risk of THA dislocation due to soft tissue impingement or tissue levering the joint out of place
Dr. Bedard says infection after TKA and THA is a significant risk for patients with 40-plus BMI, often leading to one or two additional surgeries and worse function.
Yet, despite greatly increased TKA or THA risks and challenges for those with morbid obesity, these patients are still debilitated by arthritis, and the need persists to help them.
"It's hard to deny someone a procedure just based on BMI cutoff," says Dr. Bedard, considering the example of a patient who has a BMI of 52 and who smokes cigarettes and has diabetes, and how additional comorbidities like these compound each other. "We work with them individually to modify their risk factors to improve the likelihood of getting them through surgery safely."
According to Dr. Bedard, patients with morbid obesity who do not experience any complications post-TKA or post-THA do as well as patients with lower BMI after surgery, experiencing good outcomes, including decreased pain and improved function.
"Patients with morbid obesity can have similar functional increases after TKA or THA as patients with lower BMI who have the surgery," says Dr. Bedard. "The vast majority get through surgery successfully. The main difference is comparative risk, which can be 2 to 5 times higher than that of patients who have lower BMI."
He acknowledges, however, that regardless of BMI, no surgery is risk-free.
"Every surgery has risk," he says. "You have to work with the patient to say, 'What's an acceptable risk to you?'"
While Dr. Bedard emphasizes that determination of unacceptable risk level is an individual decision, for some patients needing TKA or THA, the pain level they are experiencing makes decision-making difficult. In this case, Dr. Bedard suggests the surgeon help guide them in a shared decision-making process.
About PUSM
Shenyang Pusman Medical Equipment Co., Ltd. was established in 2006. It is a professional enterprise integrating R & D, manufacturing and sales. It specializes in producing medical equipment according to national standards. Our company's main products: medical electric saw drill series; imported brushless motor series; domestic high-quality brushless motor series; medical electric drill pendulum saw integrated multi-functional system; hand, foot and ankle special system; pedicle screw screwing into special power; external Fixed needles are screwed into special power; external fixation series; bone cement system; bone cement guns and other orthopedic surgical instruments.
Advantages of PUSM Power Tool
Integrated design, good sealing; integrated host provides you with efficient and stable output; reasonable distribution of the weight of the host from top to bottom, the user's hands are not tired; ergonomic design, comfortable feel; Suited sterilization box.
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