Body weight and successful recovery after TKR's

Posted , 12 users are following.

A colleague has expressed a desire for a knee replacement and she was told by her MD that she needs to lose a minimum of 10 kgs (preferably 20 kgs) before she can be considered for a TKR on our Medicare health system, here in Australia. The wait time at her local hospital is 4 months.

 

I guess, after smoking, obesity is a major cause of health issues in candidates for surgery. Should being overweight cause delays in surgery for otherwise healthy people?

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23 Replies

  • Posted

    Hi Lynn, Lin here I guess it is different from country to country and may even differ from state to state within that country. I am in U.K. And did wonder if being overweight, as I was, would affect my surgery but thankfully not. Due to chronic pain in both knees I had gained weight but this was not mentioned to me and I have both knees replaced. 

    I have since the surgery lost 12 kilos and plan to lose more. I hope your friend gets what she needs!

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  • Posted

    Interesting question Lyn.

    I am overweight. Before I start experiencing knee problems, I did forest walking and beach walking, plus swimming etc. to manage my weight. My walks were any distance from 4km - 12 km, depending on weather, location and time available.

    Then when my knee got so bad I couldn't walk 100 metres without severe pain.

    So it became more and more difficult to exercise.

    Having the TKR was more about my heart than my knee. I am 56 and must keep walking to stay fit and healthy.

    I did try to lose weight to avoid TKR but I found dieting without exercise didn't work for me.

    IF your friend could lose the weight , great. But if not she should be allowed to have surgery.

    Surely she is entitled to the same rights as others and if she is/has been a tax payer, even more so.

    Right now, post op, I just cannot wait to walk, walk, walk. Just like Forest Gump.

    These are my personal opinions.

    Take care,

    Alan

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  • Posted

    Nova Scotia, Can, here. My neighbor was told to loose a 100 lbs before they would consider it. He has lost some and his knees are feeling better. Carrying extra weight is hard in the knees, but it certainly catch 22. I guess by being over weight, esp the knee area it must cause a lot of blood loss, I'm just guessing. And for sure harder to get at the joint. I know I can't wait to be walking non stop again! Hopefully she gets her weight down a bit but she will still need it done regardless. Maybe change Drs. 
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  • Posted

    Can only speak from experience and observation.  I had double, TKR about four years ago, and recovered very quickly.  I did notice two patients whom I had met prior to surgery, both younger and much heavier than myself, have difficulty recovering.  Logically, being heavy (which I am not) will cause knee failure sooner than in a "normal" weight individual.  Our knees were likely not designed to handle the extra wear and tear.  In fact my knee degeneration started from bicycle and motorcycle crashes.  Not just age and use.  Honestly, though, unsure if being heavy affects healing after surgery.  That said, you do not have to walk to lose.  Have you tried a stationary bike? 
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  • Posted

    Hi Lyn, When my knee started playing up 6 years ago I lost 4 stone but my knee just got worse anyway. I loved to walk and would have walked over an hour daily (at an incredibly fast pace..noone would come with me as they said I walked too fast!) which i have really missed this last 9 months as has my wee dog. I am so looking forward to getting back out with her. I have put on around a stone agian over the last year due to inactivity but am now trying to get back on loosing it again. It is a vicious circle.

    As for the weight loss my friend needs a hip done and has been told to loose weight (around 3 stone) she asked why as is in severe pain and was told it is to help with the op..her heart and then will aid her recovery. She won't be put on waiting list till seen to be losing weight as they say it will hinder her in theatre as well as post op. Apart from weight she is fine..no bloopd pressure or any other issues.

     

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  • Posted

    Hi lyn32416,

    I had my TKR in Jan and was advised by my consultant that as long

    as my bmi was below 40 he would operate. Unfortunately my bmi was

    slightly over and had to loose a bit of weight to bring it down, I managed

    to lose about 40lbs and my bmi dropped to 35.

    I am in the UK and had my surgery done in a private hospital as a NHS

    patient.

    I suppose it depends on the surgeon.

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  • Posted

    I wish I had lost weight before the surgery as most of my weight is in my thigh area and it makes bending more difficult especially behind the knee. Those with thinner legs seem to recover much faster.
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  • Posted

    I definitely have damaged my joints by being 130lbs overweight in my 30s and 40s.  I lost the weight and have kept it off.  I don't believe it's a coincidence that my rt hip and knee both have been replaced and my lft knee is on its way out.   I read the other day for every pound of excess weight you carry means a 4lb of pressure goes through that knee. 

    I wish I had lost weight years and years ago. 

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  • Posted

    This is not an unusual deman from a surgeon. Obesity has so many negatives starting from the dangers of surgery of any kind to the inability for the body to recover and the fact the new joint can't handle the weight and the body can't rejuvenate itself. I've known 3 people who have been refused surgery because of weight problems. One guy went to enough Dr's that he finally found someone who would do it an had a hard time all the way through the process. He's in his '50's and my never see his '60's but doesn't seem to care enough to do anything about it except eat and drink more. He has his PhD which tells you that you can't always equate education and intelligence
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  • Posted

    I had my TKR March 21st 2011. I had a 6 week run up before the operation which I used wisely. Luckily I had very little pain in the knee so I could exercise vigorously. I used the 6 weeks before my operation to get in the best shape I could. I also went on a strict Paleo Diet, cut out all sugar and dropped about 10lbs. I was 30lbs over my ideal weight when I had the operated but felt strong and ready to be 18 years old again (I was 63 at the time). It was hard to get back to where I was let alone get better than I was. In the early days of recovery I pushed it hard and ended up depressed at the lack of mobility and pain that just wouldn’t go away, I gave up, became a Coach Potato and gained 40lbs. The pain and mobility got worse as the years piled up, finally I went back to see my doctor hoping upon hope that the knee had failed and I could get a new one. X rays showed that, where the knee was attached to the bone was strong and intact, it was all a soft tissue problem and I could fix it if I would be willing to lose weight and do the work to strengthen and stretch the muscles and related soft tissue. The doctor doesn’t care about soft tissue and really shouldn’t, my weight, depression, strength or lack thereof and mobility are not the surgeons concern nor should they be. I started working out in September of 2015 4.5 years after the operation and have made great progress, running (just a little) jumping rope (a lot) and doing Crossfit. I have lost 35lbs and can now walk pain free. I believe the TKR just gives you the possibility not a guarantee, I know that my giving up and not staying fit was the source of my pain not the other way around. I would just recommend lose as much weight as you can on the front end it will pay great dividend on the back end, also be patient, gentle with yourself, and most of all don’t give up you can and will have a better life.
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  • Posted

    Thank you all very much for your input. I was not surprised that she was told to lose weight. It has become a real issue for many surgeons, as there are so many lean people wanting knee and hip replacements. In my home town, people can wait 12 months. It is very much who you know and how connected your GP is to a group of referring specialists. I am on a mission to help her get fit. Thanks again.
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    • Posted

      Hi Lyn,

      I wish you and your friend the best of luck.

      One thing I have learned over the years is no matter where you and no matter what you do, it is all about 'Who you know'.

      It's just the way it is. And remember EVERYONE is a contact, you never know who knows who, and you never know where or vwhen. It could be a work colleague, a neighbour, a stranger in a supermarket Queue, a stranger you meet on vacation, anyone, anytime, anywhere. Even one of those corrupt people called politicians ☺

      Having a scan through the recent posts on cost of TKR might help, some countries cost a lot less than others, I think I seen one post of 7k. If there is anything I can do to help from this end, send me an email by using the email icon at the side of this post.

      I really wish you the best and your friend is lucky to have a good friend like you.

      Take care,

      Alan

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  • Posted

    I was told bmi had to be under 40 to have operation. My friend who was a large lady was told she could have the op but she needed to loose a consideable amount of weight first she was about 24 stone she did try but due to a thyroid problem that gps wouldn't treat she found it hard and think she gave up trying unfortunately she died from a dvt a month ago 
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