Rankin Kelsey A, Gibson David, Schwarzkopf Ran, O'Connor Mary I, Wiznia Daniel H
Yale School of Medicine, New Haven, CT, USA.
New York University Langone, New York, NY USA.
Arthroplast Today. 2022 Aug 29;17:120-125. doi: 10.1016/j.artd.2022.07.016. eCollection 2022 Oct.
Obesity, defined as a body mass index (BMI) >30, is associated with an increased likelihood of osteoarthritis and need for total joint arthroplasty (TJA). Unfortunately, the morbidly obese population has a higher risk of postoperative complications. For some surgeons, patient selection criteria for TJA includes BMI<40. The associated risks are recognized by The American Association of Hip And Knee Surgeons, and many surgeons follow these guidelines. Importantly, as obese patients have been demonstrated to have equal or greater gains in functional outcomes and quality of life metrics, it is important for obese patients to have access to TJA. Through a comprehensive literature review and structured interviews with leading surgeons in the field, we provide guidance for orthopedic surgeons treating patients with BMI>40 to minimize risks, including tailored preoperative, intraoperative, and postoperative considerations.
肥胖定义为体重指数（BMI）大于30，与骨关节炎风险增加以及全关节置换术（TJA）需求相关。不幸的是，病态肥胖人群术后并发症风险更高。对于一些外科医生而言，TJA的患者选择标准包括BMI<40。美国髋膝关节外科医生协会认识到了相关风险，许多外科医生遵循这些指南。重要的是，由于已证明肥胖患者在功能结局和生活质量指标方面有相同或更大的改善，因此肥胖患者能够接受TJA很重要。通过全面的文献综述以及对该领域顶尖外科医生的结构化访谈，我们为治疗BMI>40患者的骨科医生提供指导，以将风险降至最低，包括术前、术中和术后的针对性考量。
