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The Obesity Epidemic and its Relevance to the Knee Surgeon

Gordon N Gillespie, FRCS (Tr&Orth), and Andrew J Porteous, FRCS (Tr&Orth)

In this article, the current literature on obesity and its effects on the knee is reviewed. Obesity is an important factor in the development of symptomatic knee pain and disability, patellofemoral and meniscal pathology, and osteoarthritis (OA), as well as in the progression of OA. Therefore, the increasing prevalence of obesity means that a disproportionately high percentage of total knee arthroplasty (TKA) patients are obese. Obesity is also an independent risk factor for many serious complications of TKA, and implant survivorship may be seriously compromised in the obese patient. Rehabilitation following TKA is slower and more costly in the obese patient, and functional outcomes are worse than in the non-obese. However, it is possible for marked improvements on preoperative function to be achieved if complications do not ensue. Treating obesity has a direct beneficial impact on knee pain and function, and various interventions for obesity are discussed in the article. The authors conclude that primary prevention of knee problems using interventions aimed at reducing obesity levels must be a priority, and that this would be cost-effective in the long-term by reducing the incidence of knee pathology as well as improving surgical outcomes following TK.Adv Orthop 2008;1(1);10-6.

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