Timbang, Obesidad at Kalusugan ng Kasu-kasuan Impormasyon

Ano ito

Ang obesity ay higit pa sa mekanikal na pagkarga sa iyong mga kasu-kasuan. Ito ay isang sistematikong sakit na nagdudulot ng malalim na pamamaga, na maaaring makasama sa kalusugan ng kasu-kasuan sa paglipas ng panahon. Ang mataas na body mass index (BMI) ay nagpapataas ng iyong panganib ng arthritis na dulot ng pagkasira at pagkasuot sa iyong mga tuhod at kamay, anuman ang iyong kalusugang metaboliko. Ang pamamaga at sobrang timbang na ito ay maaaring pabilisin ang pag-unlad ng arthritis, lalo na pagkatapos ng mga sugat tulad ng mga tear ng meniscus.

Ang iyong doktor ay isinasaalang-alang ang iyong body mass index kapag nagpaplano ng iyong paggamot, ngunit hindi ito mahigpit na hadlang sa operasyon. Ang kasalukuyang ebidensya ay hindi sumusuporta sa paggamit ng body mass index lamang upang i-exclude ka mula sa primary total joint arthroplasty. Ang body mass index na higit sa 40 ay hindi nauugnay sa maagang komplikasyon sa mga ambulatory surgical centers. Ang body mass index na 45 ay itinuturing na ligtas na cut-off para sa cementless total knee arthroplasty. Gayunpaman, limitado ang datos para sa body mass index na higit sa o katumbas ng 45, kaya ang iyong doktor ay masusing ebalwuhin ang iyong partikular na kaso.

Ang pagtuon sa pamamahala ng mga umiiral na kondisyon sa kalusugan at ang pagpaplano ng operasyon na angkop sa iyo ay maaaring tumulong upang makamit mo ang mga resulta na katumbas ng mga pasyente na may normal na body mass index. Habang ang obesity ay nagpapataas ng panganib ng mekanikal na pagkabigo sa ilang robotic-assisted knee surgeries, ang mga modernong teknik ay nagbawas ng maraming tradisyonal na panganib. Ang pag-aalala sa stiffness o reoperation ay hindi dapat humadlang sa paggawa ng operasyon kapag kinakailangan sa klinika. Ang iyong doktor ay mag-aangkop ng pamamaraan sa iyong anatomiya at kalagayan ng kalusugan upang bigyan ka ng pinakamataas na pagkakataon para sa matagumpay na paggaling.

Gumagana ba ito?

Oo, ang joint replacement ay karaniwang gumagana nang maayos para sa mga pasyenteng may mataas na timbang ng katawan. Ang mga makabagong kasanayan sa operasyon at disenyo ng implant ay nagbawas ng maraming tradisyonal na panganib. Maaaring makamit ng iyong doktor ang mga resulta na katumbas ng mga pasyenteng may normal na timbang sa pamamagitan ng pamamahala ng mga kondisyon sa kalusugan bago ang operasyon at maingat na pagpaplano. Ang body mass index na 45 ay itinuturing na ligtas na hangganan para sa cementless knee replacement. Gayunpaman, masyadong maliit ang laki ng sample upang makabuo ng matibay na konklusyon para sa mga pasyenteng may body mass index na 45 o higit pa.

Ang obesity ay isang systemic na sakit na nakakaapekto sa kalusugan ng joint higit pa sa simpleng mechanical stress. Pinataas nito ang pamamaga sa katawan. Hindi ito nangangahulugan na hindi ka makakapagkaroon ng operasyon. Halimbawa, hindi pinataas ng obesity ang panganib ng impeksyon o revision surgery pagkatapos ng shoulder replacement. Hindi rin nito pinataas ang panganib ng stiffness pagkatapos ng knee manipulation. Sa katunayan, ang hip arthroscopy para sa sakit sa balakang ay nagdudulot ng long-term na pagpapabuti sa mga obese na pasyente na katumbas ng mga nasa mga pasyenteng may normal na timbang.

May ilang mga aspeto kung saan limitado o magkakaiba-iba ang ebidensya. Ang kasalukuyang datos tungkol sa tibial stem extensions sa knee replacement para sa mga obese na pasyente ay hindi sapat. Hindi namin maaaring karaniwang irekomenda ang mga ito dahil sa mababang certainty ng datos. Maaaring tumulong ang mga partikular na disenyo sa mga napiling indibidwal, ngunit kailangan pa ng mas maraming pananaliksik. Ang mataas na body mass index ay nauugnay sa mas mataas na mga rate ng mechanical failure sa robotic knee replacements. Pinataas din ng obesity ang panganib ng revision pagkatapos ng knee arthroscopy at unicompartmental knee replacement.

Kung ikaw ay nag-aalala ng operasyon, ay susuriin ng iyong doktor ang iyong mga partikular na panganib. Ang Type 2 diabetes ay hindi isang independent na risk factor para sa reoperation kapag inayos para sa body mass index. Ang Semaglutide ay tila isang ligtas na alternatibo sa bariatric surgery para sa pamamahala ng timbang bago ang hip replacement. Nag-aalok ito ng katulad na survival ng implant at mga rate ng komplikasyon. Habang pinataas ng obesity ang panganib ng lahat-cause revisions sa shoulder replacement para sa mga fracture, hindi nito pinataas ang panganib ng impeksyon sa ibang mga prosedura sa balikat. Gagamitin ng iyong doktor ang ebidensyang ito upang i-tailor ang iyong plano ng pag-aalaga.

Tama ba ito para sa iyo?

Maaaring irekomenda ng iyong doktor ang pagpapalit ng kasukasuan kung mayroon kang malubhang arthritis na sanhi ng matinding pagkasira na nakakapaglimita sa iyong pang-araw-araw na buhay. Ang kasalukuyang ebidensya ay nagpapakita na ang mataas na body mass index (BMI) ay hindi awtomatikong nagpapaalis sa iyo bilang kandidato. Halimbawa, ang body mass index na higit sa 40 ay hindi nauugnay sa maagang mga komplikasyon sa mga setting ng ambulatory care. Ang body mass index na 45 ay itinuturing din na ligtas na hangganan para sa ilang mga operasyon ng pagpapalit ng tuhod. Maaari ng iyong doktor na pamahalaan ang mga umiiral nang kalusugan at magplano nang maingat sa iyong operasyon upang makamit ang mga resulta na katulad ng mga may mas mababang timbang ng katawan.

Ang obesity ay nakakaapekto sa kalusugan ng kasukasuan sa pamamagitan ng systemic inflammation, hindi lamang mechanical stress. Ibig sabihin, maaari kang harapin ang mga partikular na panganib depende sa ginagawang prosedura. Mas mataas ang rate ng revision pagkatapos ng partial knee replacements sa mga pasyenteng obese. Nakakaharap din sila sa mas mataas na panganib ng pagkaluwag o kawalan ng katatagan ng implant pagkatapos ng shoulder replacements para sa mga fracture. Gayunpaman, ang mga modernong teknika sa operasyon at mga implant ay nagbawas ng maraming tradisyonal na panganib na nauugnay sa mas mataas na timbang ng katawan.

Kung ikaw ay nag-iisip ng operasyon sa balikat, ang obesity ay hindi nauugnay sa pangangailangan para sa mga future reoperations. Ang Semaglutide ay tila isang ligtas na opsyon para sa pamamahala ng timbang bago ang hip replacement, na may mga resulta na katulad ng bariatric surgery. Para sa mga alalahanin sa stiffness ng tuhod, ang pagtaas ng kabigatan ng obesity ay hindi nagdudulot ng mas masamang mga resulta pagkatapos ng manipulation under anesthesia.

Tutuklasin ng iyong doktor ang iyong partikular na profile ng kalusugan. Itataya nila kung ikaw ay isang mahusay na kandidato batay sa higit pa lamang sa iyong timbang. Ang desisyong ito ay dapat ibahagi sa pagitan ng iyo at ng iyong medical team.

Ang pangunahing punto

Maaaring ligtas na isagawa ng iyong doktor ang pagpapalit ng kasukasuan kahit mataas ang body mass index (BMI) mo. Ang BMI na hanggang 45 ay itinuturing na ligtas na hangganan para sa operasyon ng tuhod. Ang mas mataas na timbang ay hindi nagpapataas ng iyong panganib ng maagang komplikasyon o katigasan. Maaari kang maghanda ng mga resulta na katulad ng mga taong may normal na timbang. Ang pinakamahalagang paalala ay ang pagka-obeso ay nagpapataas ng pamamaga sa iyong mga kasukasuan. Ang epektong ito sa buong katawan ay maaaring makaapekto sa pangmatagalang kalusugan ng kasukasuan, higit pa sa mekanikal na stress.

Evidence & references

Overview

Body Mass Index greater than 40 is not correlated with early complications in patients undergoing primary total joint arthroplasty at an ambulatory surgical center [1].
Focusing on management of preoperative comorbidities and custom surgical planning can achieve outcomes comparable to those of patients with normal BMIs at ambulatory surgical centers [1].
BMI should not be used as an exclusion criterion for arthroplasty based on current evidence [1].
A BMI of 45 is a safe cut-off for cementless total knee arthroplasty, though sample sizes were too small to draw conclusions for patients with a BMI greater than or equal to 45 [2].
Body mass index does not affect clinical outcomes following arthroscopically assisted posterior latissimus dorsi tendon transfer for irreparable posterosuperior rotator cuff tears [3].
No significant differences were observed between above-average and below-average BMI groups in clinical outcomes for posterior latissimus dorsi tendon transfer [3].
BMI was not correlated with clinical improvements in posterior latissimus dorsi tendon transfer [3].
Obesity is a systemic disease with profound inflammatory consequences on joint health, extending beyond being a mechanical burden on the knee [4].
Increasing obesity severity is not associated with higher rates of postoperative stiffness following total knee arthroplasty [5].
Increasing obesity severity is not associated with inferior outcomes following manipulation under anesthesia for stiffness after total knee arthroplasty [5].
Concern for stiffness alone should not serve as a categorical barrier to total knee arthroplasty or manipulation under anesthesia when clinically indicated [5].
WHO obesity class does not associate with the incidence of reoperations after total hip arthroplasty [6].
WHO obesity class does not associate with the timing of reoperations after total hip arthroplasty [6].
WHO obesity class does not associate with the invasiveness of reoperations after total hip arthroplasty [6].
Current evidence does not support the routine use of tibial stem extensions in obese total knee arthroplasty patients due to insufficient, heterogeneous, and very low certainty data [7].
Specific tibial stem extension designs may benefit selected populations of obese total knee arthroplasty patients [7].
Obese and overweight patients converted to total hip arthroplasty at significantly higher rates compared with normal-weight patients after hip arthroscopy for femoroacetabular impingement syndrome [13].
Patients with obesity had greater than 2-fold odds of conversion to total hip arthroplasty after hip arthroscopy for femoroacetabular impingement syndrome [17].
Ten-year functional outcomes and revision rates of total hip arthroplasty do not justify restricting access to surgery on the basis of BMI [28].

How It Works

Obesity is a systemic disease with profound inflammatory consequences on joint health, extending beyond being a mechanical burden on the knee [4].
High body mass index elevates the risk of both knee and hand osteoarthritis irrespective of metabolic status [23].
The increased risk of knee osteoarthritis attributed to high BMI is more evident in metabolically healthy participants [23].
Obesity and preexisting osteoarthritis are known risk factors for predicting poor outcomes and conversion to arthroplasty after knee arthroscopy [14].
Following medial meniscus posterior root tear repair, osteoarthritis progression shows higher rates with elevated body mass index [20].
Body mass index has a weak-to-moderate association with peri-incisional adiposity in primary total joint arthroplasty patients [10].
Body mass index is not an appropriate proxy for the condition of peri-incisional adiposity in primary total joint arthroplasty patients [10].
The soft tissue-to-bone ratio reflects local anatomical factors that directly influence surgical exposure and wound healing, outperforming body mass index in predicting periprosthetic joint infection in total knee arthroplasty [19].
Body mass index greater than 40 is not correlated with early complications in patients undergoing primary total joint arthroplasty at an ambulatory surgical center [1].
Focusing on management of preoperative comorbidities and custom surgical planning can achieve outcomes comparable to those of patients with normal body mass index at ambulatory surgical centers, questioning body mass index as an exclusion criterion [1].
Body mass index of 45 is a safe cut-off for cementless total knee arthroplasty, although sample sizes were too small to draw conclusions in patients with a body mass index greater than or equal to 45 [2].
Body mass index does not affect clinical outcomes following arthroscopically assisted posterior latissimus dorsi tendon transfer for irreparable posterosuperior rotator cuff tears, with no significant differences observed between above-average and below-average body mass index groups [3].
Increasing obesity severity is not associated with higher rates of postoperative stiffness or inferior outcomes following manipulation under anesthesia after total knee arthroplasty [5].
Concern for stiffness alone should not serve as a categorical barrier to total knee arthroplasty or manipulation under anesthesia when clinically indicated [5].
World Health Organization obesity class does not associate with incidence, timing, or invasiveness of reoperations after total hip arthroplasty [6].
Modern surgical practices and implant designs may have mitigated traditional obesity-related risks, showing minimal impact on loosening and mechanical failure in total knee arthroplasty [8].
High body mass index is associated with comparable functional outcomes but higher mechanical failures in functionally aligned image-based robotic total knee arthroplasty [11].
Obesity remains a critical risk factor for mechanical failures in total knee arthroplasty [11].
A nonsignificant trend toward a higher complication rate was observed in patients with severe obesity (body mass index greater than or equal to 35 kg/m2) in robotic-assisted total knee arthroplasty [21].
A statistically significant increase in arthrofibrosis was found in patients with a body mass index less than 25 kg/m2 in robotic-assisted total knee arthroplasty [21].
Findings support a body mass index-based approach to perioperative semaglutide use, particularly in patients with a body mass index greater than 30 [22].
Type 2 diabetes is not an independent risk factor for reoperation when adjusted for body mass index in obese patients undergoing total hip arthroplasty [24].
Obesity had a negative influence on lower extremity long bone fracture in-hospital outcomes in pediatric patients [9].
Women had decreased odds of losing greater than five pounds before surgery despite increased odds of having preoperative bariatric surgery in the context of total joint arthroplasty disparities [12].

What the Evidence Shows

BMI > 40 is not correlated with early complications in patients undergoing primary total joint arthroplasty at an ambulatory surgical center [1].
Focusing on management of preoperative comorbidities and custom surgical planning can achieve outcomes comparable to those of patients with normal BMIs at ambulatory surgical centers [1].
BMI should not be used as an exclusion criterion for total joint arthroplasty at ambulatory surgical centers [1].
BMI of 45 is a safe cut-off for cementless total knee arthroplasty, though sample sizes were too small to draw conclusions for patients with BMI ≥ 45 [2].
BMI does not affect clinical outcomes following arthroscopically assisted posterior latissimus dorsi tendon transfer for irreparable posterosuperior rotator cuff tears [3].
No significant differences were observed between above-average and below-average BMI groups in clinical improvements after arthroscopically assisted posterior latissimus dorsi tendon transfer [3].
BMI is not correlated with clinical improvements after arthroscopically assisted posterior latissimus dorsi tendon transfer [3].
Obesity is a systemic disease with profound inflammatory consequences on joint health, extending beyond being a mechanical burden on the knee [4].
Increasing obesity severity is not associated with higher rates of postoperative stiffness following total knee arthroplasty [5].
Increasing obesity severity is not associated with inferior outcomes following manipulation under anesthesia (MUA) for stiffness after total knee arthroplasty [5].
Concern for stiffness alone should not serve as a categorical barrier to total knee arthroplasty or MUA when clinically indicated [5].
WHO obesity class does not associate with the incidence, timing, or invasiveness of reoperations after total hip arthroplasty [6].
Current evidence does not support the routine use of tibial stem extensions in obese total knee arthroplasty patients due to insufficient, heterogeneous, and very low certainty data [7].
Specific tibial stem extension designs may benefit selected populations of obese total knee arthroplasty patients [7].
Modern surgical practices and implant designs may have mitigated traditional obesity-related risks of loosening and mechanical failure in total knee arthroplasty [8].
Obesity has a negative influence on lower extremity long bone fracture in-hospital outcomes in pediatric patients [9].
BMI has a weak-to-moderate association with peri-incisional adiposity in primary total joint arthroplasty patients [10].
BMI is not an appropriate proxy for the condition of peri-incisional adiposity in primary total joint arthroplasty patients [10].
High body mass index is associated with comparable functional outcomes but higher mechanical failures in functionally aligned image-based robotic total knee arthroplasty [11].
Obesity remains a critical risk factor for mechanical failures in functionally aligned image-based robotic total knee arthroplasty [11].
Women had decreased odds of losing greater than five pounds before total joint arthroplasty despite increased odds of having preoperative bariatric surgery [12].
Obese and overweight patients converted to total hip arthroplasty at significantly higher rates compared with normal-weight patients after hip arthroscopy for femoroacetabular impingement syndrome [13].
Obesity and preexisting osteoarthritis are risk factors for predicting poor outcomes and conversion to arthroplasty after knee arthroscopy [14].
Obesity is associated with an increased risk of all-cause revisions and revision for instability or dislocation in patients receiving reverse total shoulder arthroplasty indicated for fractures [15].
Semaglutide appears to be a safe alternative to bariatric surgery for weight management before total hip arthroplasty [16].
Semaglutide is associated with similar implant survival and postoperative complication rates compared to bariatric surgery for weight management before total hip arthroplasty [16].
Patients with obesity had greater than 2-fold odds of conversion to total hip arthroplasty after hip arthroscopy for femoroacetabular impingement syndrome [17].
Obese patients are at increased risk of higher rates of revision following unicompartmental knee arthroplasty [18].
Dual mobility implants demonstrated excellent five-year survivorship with outcomes comparable or slightly superior to fixed-bearing constructs in morbidly obese patients undergoing primary total hip arthroplasty [25].
Total weight loss percentage was higher in bariatric surgery patients compared to those undergoing immediate total knee arthroplasty [26].
Lower body mass index and symptom burden are observed in modern hip arthroscopy patients, with improved patient-reported symptoms at the time of surgery [27].
Elevated BMI is associated with weak-to-moderate increases in thromboembolic risk after total shoulder arthroplasty [29].
Elevated BMI is not associated with infection or revision surgery risk after total shoulder arthroplasty [29].

Practical Considerations

BMI > 40 is not correlated with early complications in patients undergoing primary total joint arthroplasty at an ambulatory surgical center [1].
Focusing on management of preoperative comorbidities and custom surgical planning can achieve outcomes comparable to those of patients with normal BMIs at ambulatory surgical centers [1].
BMI should not be used as an exclusion criterion for primary total joint arthroplasty at ambulatory surgical centers [1].
BMI of 45 is a safe cut-off for cementless total knee arthroplasty [2].
Conclusions regarding safety cannot be drawn for patients with BMI ≥ 45 due to small sample sizes [2].
BMI does not affect clinical outcomes following arthroscopically assisted posterior latissimus dorsi tendon transfer for irreparable posterosuperior rotator cuff tears [3].
No significant differences were observed between above-average and below-average BMI groups in clinical outcomes after arthroscopically assisted posterior latissimus dorsi tendon transfer [3].
BMI was not correlated with clinical improvements after arthroscopically assisted posterior latissimus dorsi tendon transfer [3].
Obesity is a systemic disease with profound inflammatory consequences on joint health, extending beyond being a mechanical burden on the knee [4].
Increasing obesity severity is not associated with higher rates of postoperative stiffness following total knee arthroplasty [5].
Increasing obesity severity is not associated with inferior outcomes following manipulation under anesthesia (MUA) for stiffness after total knee arthroplasty [5].
Concern for stiffness alone should not serve as a categorical barrier to total knee arthroplasty or MUA when clinically indicated [5].
WHO obesity class does not associate with the incidence, timing, or invasiveness of reoperations after total hip arthroplasty [6].
Current evidence does not support the routine use of tibial stem extensions in obese total knee arthroplasty patients due to insufficient, heterogeneous, and very low certainty data [7].
Specific tibial stem extension designs may benefit selected populations of obese total knee arthroplasty patients [7].
Modern surgical practices and implant designs may have mitigated traditional obesity-related risks of loosening and mechanical failure in total knee arthroplasty [8].
Obesity had a negative influence on lower extremity long bone fracture in-hospital outcomes in pediatric patients [9].
BMI has a weak-to-moderate association with peri-incisional adiposity in primary total joint arthroplasty patients [10].
BMI is not an appropriate proxy for the condition of peri-incisional adiposity in primary total joint arthroplasty patients [10].
High body mass index is associated with comparable functional outcomes but higher mechanical failures in functionally aligned image-based robotic total knee arthroplasty [11].
Obesity remains a critical risk factor for mechanical failures in functionally aligned image-based robotic total knee arthroplasty [11].
Women had decreased odds of losing greater than five pounds before total joint arthroplasty despite increased odds of having preoperative bariatric surgery [12].
Obese and overweight patients converted to total hip arthroplasty at significantly higher rates compared with normal-weight patients after hip arthroscopy for femoroacetabular impingement syndrome [13].
Obesity is associated with an increased risk of all-cause revisions and revision for instability or dislocation in patients receiving reverse total shoulder arthroplasty indicated for fractures [15].
Obese patients are at increased risk of higher rates of revision following unicompartmental knee arthroplasty [18].
Semaglutide appears to be a safe alternative to bariatric surgery for weight management before total hip arthroplasty [16].
Semaglutide and bariatric surgery have similar implant survival and postoperative complication rates for patients undergoing total hip arthroplasty [16].

Key Evidence

[L3] Focusing on management of preoperative comorbidities and custom surgical planning can achieve outcomes comparable to those of patients who have normal BMIs at ASCs, questioning BMI as an exclusion criterion and advocating for more inclusive, evidence-based patient selection. [1] (10.1016/j.arth.2025.08.065)
[L3] However, the numbers were too small to draw conclusions in patients who have a BMI ≥ 45. [2] (10.1016/j.arth.2025.12.038)
[L2] No significant differences were observed between above-average and below-average BMI groups, and BMI was not correlated with clinical improvements. [3] (10.1016/j.xrrt.2025.100634)
[L5] Obesity is more than a mechanical burden on the knee; it is a systemic disease with profound inflammatory consequences on joint health. [4] (10.1002/arj.70051)
[L3] These findings suggest that increasing obesity severity is not associated with higher rates of postoperative stiffness or inferior outcomes following MUA and that concern for stiffness alone should not serve as a categorical barrier to TKA or MUA when clinically indicated. [5] (10.1016/j.arth.2026.03.080)
[L3] In this cohort of obese patients who underwent THA, the WHO obesity class was not associated with risk, invasiveness, or timing of reoperations. [6] (10.1016/j.arth.2025.07.026)
[L5] The authors conclude that current evidence does not support the routine use of tibial stem extensions in obese total knee arthroplasty patients due to insufficient, heterogeneous, and very low certainty data, though specific designs may benefit selected populations. [7] (10.1016/j.arth.2025.11.056)
[L3] These findings suggest modern surgical practices and implant designs may have mitigated traditional obesity-related risks. [8] (10.1016/j.arth.2026.04.031)
[L4] Overall, these findings suggested that obesity had a negative influence on lower extremity long bone fracture in-hospital outcomes. [9] (10.1186/s12891-025-09349-6)
[L3] BMI has a weak-to-moderate association with peri-incisional adiposity in primary total joint arthroplasty patients. [10] (10.1016/j.arth.2024.08.020)
[L3] However, obesity remains a critical risk factor for mechanical failures. [11] (10.1016/j.jisako.2025.100861)
[L3] Women had decreased odds of losing greater than five pounds before surgery despite increased odds of having preoperative bariatric surgery. [12] (10.1016/j.arth.2026.06.021)
[L3] Obese and overweight patients converted to THA at significantly higher rates compared with normal-weight patients. [13] (10.1177/03635465251400355)
[L5] Obesity and preexisting osteoarthritis are known risk factors for predicting poor outcomes and conversion to arthroplasty after knee arthroscopy, but the study lacks a control group and specific procedural details to determine if the surgery itself drives progression versus patient factors. [14] (10.1016/j.arthro.2025.04.036)
[L3] Obesity has an increased risk of all-cause revisions and revision for instability or dislocation in patients receiving rTSA indicated for fractures. [15] (10.1016/j.jse.2025.05.036)
[L3] Semaglutide appears to be a safe alternative to bariatric surgery for weight management before THA, with similar implant survival and postoperative complication rates. [16] (10.1016/j.arth.2025.08.068)
[L3] However, patients with obesity had >2-fold odds of conversion to THA. [17] (10.1177/03635465251392585)
[L3] Based on AOANJRR data, obese patients are at increased risk of higher rate of revision following UKA. [18] (10.1177/2325967125s00336)
[L3] Unlike BMI, the STiB ratio reflects local anatomical factors that directly influence surgical exposure and wound healing. [19] (10.1016/j.arth.2025.09.022)
[L1] Following MMPRT repair, repairs show progression of osteoarthritis with higher rates seen with elevated BMI. [20] (10.1002/arj.70028)
[L2] However, a nonsignificant trend toward a higher complication rate was observed in patients with severe obesity (BMI ≥35 kg/m2), while a statistically significant increase in arthrofibrosis was found in patients with BMI <25 kg/m2. [21] (10.1016/j.jisako.2025.100927)
[L3] Our findings support a BMI-based approach to perioperative semaglutide use, particularly in patients who have a BMI >30. [22] (10.1016/j.arth.2025.09.056)
[L2] High BMI elevates the risk of both knee and hand osteoarthritis irrespective of metabolic status, and the increased risk of knee osteoarthritis attributed to high BMI is more evident in metabolically healthy participants. [23] (10.1186/s12891-026-09495-5)
[L2] Overall, T2DM is not an independent risk factor for reoperation when adjusted for BMI. [24] (10.1186/s12891-026-09568-5)
[L3] In morbidly obese patients, DM implants demonstrated excellent five-year survivorship with outcomes comparable or slightly superior to fixed-bearing constructs. [25] (10.1016/j.arth.2026.03.075)
[L1] Total weight loss % was higher in bariatric surgery patients (28.7%, P < 0.001). [26] (10.1016/j.arth.2026.05.033)
[L4] This multicenter data set has demonstrated improved patient-reported symptoms at the time of surgery, a decrease in mean patient BMI, and an increase in symptom duration reported prior to surgery. [27] (10.1002/ksa.12745)
[L3] The ten-year functional outcomes and revision rates of THA do not justify restricting access to surgery on the basis of BMI. [28] (10.1016/j.arth.2025.07.044)
[L3] Elevated BMI was associated with weak-to-moderate increases in thromboembolic risk after TSA but not infection or revision surgery. [29] (10.1016/j.jse.2026.05.022)

References

[1] Body Mass Index > 40 Is Not Correlated With Early Complications in Patients Undergoing Primary Total Joint Arthroplasty at an Ambulatory Surgical Center. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2025.08.065 [2] Body Mass Index of 45 Is a Safe Cut-Off for Cementless Total Knee Arthroplasty. The Journal of Arthroplasty. 2025. DOI: 10.1016/j.arth.2025.12.038 [3] Body mass index does not affect clinical outcomes following arthroscopically assisted posterior latissimus dorsi tendon transfer for irreparable posterosuperior rotator cuff tears: a minimum 5-year follow-up study. JSES Reviews, Reports, and Techniques. 2026. DOI: 10.1016/j.xrrt.2025.100634 [4] Reframing Obesity in Knee Osteoarthritis: A Call for a Transdisciplinary Approach Beyond Biomechanics. Arthroscopy. 2026. DOI: 10.1002/arj.70051 [5] Obesity Severity and Stiffness After Total Knee Arthroplasty Revisited: A Contemporary Analysis of Patients Requiring Manipulation Under Anesthesia. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2026.03.080 [6] Obesity Class Does Not Associate With Incidence, Timing, or Invasiveness of Reoperations After Total Hip Arthroplasty. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2025.07.026 [7] Reply to: "Letter to the Editor Commenting on: 'Current Evidence Does Not Support the Use of Tibial Stem Extension in Total Knee Arthroplasty of Obese Patients: A Systematic Review'". The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2025.11.056 [8] Obesity and Total Knee Arthroplasty Revisited: Minimal Impact on Loosening and Mechanical Failure in the Modern Era. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2026.04.031 [9] Impact of pediatric obesity on surgical outcomes of lower extremity fractures: a nationwide analysis (2010–2019). BMC Musculoskeletal Disorders. 2026. DOI: 10.1186/s12891-025-09349-6 [10] Body Mass Index is Not an Appropriate Proxy for the Condition of Peri-Incisional Adiposity in Primary Total Joint Arthroplasty Patients. The Journal of Arthroplasty. 2025. DOI: 10.1016/j.arth.2024.08.020 [11] Impact of high body mass index on functionally aligned image-based robotic total knee arthroplasty: Comparable functional outcomes but higher mechanical failures. Journal of ISAKOS. 2025. DOI: 10.1016/j.jisako.2025.100861 [12] Disparities in Preoperative Weight Loss and Obesity Treatment Before Total Joint Arthroplasty. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2026.06.021 [13] The Effect of Body Mass Index on Outcomes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome: A Matched Analysis With 10-Year Follow-up. The American Journal of Sports Medicine. 2026. 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