Happiness is Happy KneesOsteoarthritis and Obesity

DR.A.V.GURAVA REDDY D. Orth, DNB Orth, FRCS (Edin), FRCS (Glas), M.Ch Orth (Liverpool)

CEO & MANAGING DIRECTOR CHIEF JOINT REPLACEMENT SURGEON

SUNSHINE HOSPITALSSECUNDERABAD

Obesity…… present day

epidemic

How common is obesity???

• 2/3 adults and 1/3 of children are obese

• Three times more than 20 years ago

• It is an established risk factor for many diseases

• It costs 3 billion pounds per year to UK

Obese people think…….

Painful and disabling disease an inevitable consequence of ageing at least for people who have the wrong genes.

Osteoarthritis and Obesity What you need to

know??

• New research shows that the obese are up to four times as likely to develop knee osteoarthritis as they are to develop high blood pressure or type-2 diabetes.

How common is osteoarthritis

• OA is most common form of arthritis.

• Increase to be substantial in next 20

years

• >1 million people visit their GP in a

year due to OA.

• Its twice prevalent than HTN and DM.

Osteoarthritis of the knee is the most prevalent formof large joint OA in the world.

Knee X-ray At Various stages

Stage III

Normal

Stage IV

Osteoporosis is not same as

Osteoarthritis

Effects of obesity on patients

• The danger to health and quality of life is insidious– at every stage,– excess body weight both increases

the level of pain and disability – and undermines the efficacy of

treatment.

• HTN and DM can be controlled with weight loss but osteoarthritis is irreversible.

Obesity and osteoarthritis How is the damage done ??

• Excessive loading of the joint -----obesity causes osteoarthritis.

• It is in the weight-bearing joints - the knee and to a lesser extent the hips

• Because of the way the knee joint works, the effect of excess weight can be four or five times greater

• Poor posture and unhealthy gait are more common in obese people,

• Osteoarthritis is the most common disease affecting the joints of the body, particularly the knees and hips.

• It is estimated that over 6 million people over the age of 45 years in the UK have painful osteoarthritis in their knees

Something about osteoarthritis

DOES EVERYBODY GET ARTHRITIS OF

KNEES?

WHAT ARE THE SYMPTOMS?

1. PAIN

2. MORNING STIFFNESS

3. SWELLING

4. CREAKING SOUNDS

5. DIFFICULTY IN SQUATTING

6. DIFFICULTY IN STAIRS

The most significant symptom is an aching, sharp or burning pain that is made worse with activity.

Eventually, the cartilage wears away completely ,worsening the pain and causing difficulty in movement

However, of preventable factors, obesity is far and away the single biggest cause of osteoarthritis in weight-bearing joints.

The earlier someone becomes overweight or obese, the greater the risk of developing osteoarthritis.

CAN WE PREVENT OA?

NO, BUT WE CAN DELAY OR SLOW

DOWN THE PROCESS

• Once entrenched, osteoarthritis is likely to have the effect of further reducing activity, bringing about increased weight gain.

• As well as worsening osteoarthritis symptoms, this further increase in weight will also raise the risk of developing other obesity-related diseases.Obesit

y

Early Osteoarthritis

Reduced Activity

Increased Weight

Obesity and Osteoarthritis –The need for

surgery

• As well as causing osteoarthritis to develop, persistent obesity increases the level of pain and disability while reducing the efficacy of pain-relieving drugs.

• 2/ 3 TKR & ¼ THR IS DUE TO OBESITY

Obesity The bad news for surgery

outcome • Knee and hip replacements are among

the great success stories of modern surgery.

• Research shows that nearly 50 per cent of obese patients have a poor outcome from joint replacement surgery compared to less than ten per cent of those with a healthy weight.

120 kg weight when he got operated

Bow legs in obesity

•WHAT EXERCISE IS GOOD??

•IS CYCLING / TREADMILL GOOD?

•ANY DIET RESTRICTIONS?

WHAT SHOULD I DO?

1.KEEP FIT

2.KEEP YOUR WEIGHT DOWN

3.NO SQUATTING

4.MINIMIZE STAIRS

Prevention is the best Medicine

• Benefits of a healthy weight– Achieving a healthy weight reduces the risk of

developing the disease in the first place, relieves existing symptoms and helps to prevent further deterioration.

• There is increasing evidence that exercise is most effective in reducing both pain and mobility when combined with weight loss.

Bariatric surgery can be helpful in such

patients to give better results of

TKR and THR

Last Resort is TKR

Am I slim enough to get TKR??

Thank “u”