Obesity Effects on Total Joint Arthroplasty Outcomes
Summary
Obesity has emerged as a pivotal factor influencing both the surgical course and long-term results of total joint arthroplasty. Excess adiposity increases biomechanical loading across hip and knee prostheses, heightens the risk of peri-operative complications such as wound dehiscence and deep infection, and may accelerate prosthesis wear. Metabolic alterations associated with adipose tissue also contribute to systemic inflammation and impaired tissue repair. Nonetheless, most individuals with raised body mass index derive substantial pain relief and functional improvement following joint replacement. Careful patient selection, optimisation of comorbidities, and tailored rehabilitation strategies are critical to mitigate risk. Weight-management interventions before surgery have been proposed to reduce adverse events, though their impact on medium-term functional recovery is variable. As global obesity prevalence continues to rise, understanding the interplay between mechanical stress, immunometabolic factors and prosthesis performance remains central to improving outcomes and guiding equitable access to joint replacement.
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Obesity Effects on Total Joint Arthroplasty Outcomes publication trend
The graph below shows the total number of articles in obesity effects on total joint arthroplasty outcomes across all publications each year (not limited to Nature Index journals).
Technical terms
Body mass index (BMI): A ratio of weight to height squared (kg/m²) used to classify underweight, normal weight, overweight and obesity.
Total joint arthroplasty (TJA): A surgical procedure replacing diseased hip or knee joints with prosthetic implants to relieve pain and restore function.
Revision surgery: A subsequent operation to replace or repair components of a previously implanted prosthesis, often due to infection, loosening or wear.
Patient-reported outcome measures (PROMs): Standardised questionnaires capturing patients’ perceptions of pain, function and quality of life following intervention.
Peri-operative complication: An adverse event occurring during or shortly after surgery, including infection, thromboembolism or wound healing problems.
References
- The effect of body mass index and preoperative weight loss in people with obesity on postoperative outcomes to 6 months following total hip or knee arthroplasty: a retrospective study. Arthroplasty (2023).
- Does body mass index influence improvement in patient reported outcomes following total knee arthroplasty? A retrospective analysis of 3918 cases. Knee Surgery & Related Research (2023).
- Obesity and revision surgery, mortality, and patient-reported outcomes after primary knee replacement surgery in the National Joint Registry: A UK cohort study. PLOS Medicine (2021).
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