We had written a blog before about the importance of being prepared for your joint replacement surgery. Going through pre-hab is just as important as rehab for many reasons. Surgery is usually the last resort of what we do trying to fix our body.
There is an important shift that occurs while we try all these non-surgical options. Some of them might work for a bit, and some do not. The only sure and known way to improve pain caused by severe arthritis is to have a joint replacement surgery. Yet it is a long journey that slows us down and keeps us less mobile.
So, what happens when we move less? You got it – weight gain, along with other issues. Excessive weight can also be a reason why a person can develop osteoarthritis of the knee – you are wearing your joints out by placing more weight and stressing out your cartilage.
Weight and Surgery Outcomes
The numbers, in this case, do not lie – each pound of weight loss offloads 5-10 pounds from the knee joint. So let us say you lose 5 pounds – your knee just got a relief by at least 25 pounds! If you are a runner (or do any other high impact activity), then the offload is 10-fold – or 50 pounds! According to this study, obese persons were over three times as likely and overweight persons were one and a half times more likely to undergo joint replacement surgery, compared to those in the acceptable weight category in 2003–04.
For hip replacement, the evidence is not as strong between obesity and the need for weight loss. However, there is a definite connection between obesity and surgical outcomes. The risks of infection and dislocation are higher. There are other complications that can occur in obese patients, such as poor wound healing, difficulty breathing, blood clots, blood loss and pulmonary embolism (blood clot in the lungs). Another issue with operating on an overweight person is low visibility for a surgeon. The veins are harder to find in order to administer IV drugs. Thus, the surgery takes longer and there is more blood loss.
Do you know your BMI?
So, are you at risk? If your BMI is greater than 30 your doctor may ask you to lose weight before scheduling the surgery. To figure out your BMI click here. In addition, if you have any secondary conditions such as hypertension or diabetes, then you are even more likely to have your surgery postponed. Weight loss can be controlled in most cases and therefore your doctor will want to reduce the risks and have you lose weight first.
In Canada, the wait list for a joint replacement can be long. The last thing you want to do is delay your surgery because of weight issues. Not only it is very discouraging, but it also keeps you away from getting better.
So what can you do? It may sound like you are in a catch 22 here – to lose weight you need to move around, and for you to move around, well you need to have the surgery done! However, there are a couple of things to try.
First and foremost, watch what and how much you are eating. Use an app on your phone such as Lose It! or MyPlate. It will tell you how much you can eat a day to lose a certain amount. It keeps progress during the day as you enter the meals you have eaten. When selecting food, make sure you include lots of fruit and vegetables and try to stay away from pre-packaged baked goods and processed meats.
Secondly, there are some exercises you can do with limited movability. It is worth it to have a session or two with a physiotherapist. She can show you exactly what will work for you in your particular case. If your resources are limited, Youtube and Google search are a good place to start. For example, this article lists 10 must do prehab exercises.
Thirdly, moving around your house, in your backyard, walking your dog, walking in the parking lot – all counts. Using an incumbent bike is easy on your joints and keeps you in motion. Swimming is a great exercise that does not bear pressure on your joints. Join your local pool or swim in the lake or ocean during summer.