Newsletter March 2020

Weight Loss Before Total Knee Replacement

Have you been told by an orthopaedic surgeon that prior to your knee replacement you need to lose some weight? If so, you may feel disappointed or upset. When your mobility range is limited such recommendations may seem unrealistic or even absurd. Should a BMI (body mass index) of 30 or more preclude your surgeon from scheduling an operation?

There is a good reason doctors make this recommendation to their patients. Our knees are weight-bearing joints and the amount of weight we put on them matters. Studies have shown that losing weight can greatly improve arthritic pain. Every pound of excess weight puts about 4 pounds of extra pressure on the knees. Every pound you lose relieves pressure and stress on the joints.

Losing weight, in general, is healthy, not just for your joints. People that are obese often suffer from certain diseases and conditions such as diabetes, hypertension, depression and others. These conditions, or secondary diseases, are called comorbidities. The more comorbidities a person has the more risk there is in surgery.

However, a relatively new study came out and it concludes that “obesity in itself should not be a deterrent to undergoing a joint replacement to relieve symptoms”. It reports that obese patients reported excellent pain relief and substantial function gain, similar to other, non-obese patients.

Yet another review of studies for total knee replacement states that obesity still contributed to a greater risk of overall complications, such as infections rates. In addition, the need for revision surgery was higher in obese patients.

So, what is the magic number of pounds to be lost prior to surgery? This study states it is 20. The researchers found that people who were morbidly obese and lost at least 20 lbs were more likely to:

  • Have shorter hospital stays
  • Be discharged to their homes, rather than to rehabilitation facilities

Talk to your doctor about the risks of your total knee replacement. If weight loss is recommended, doing so will lower these risks and ensure a successful outcome.


When Is the Right Time for Your Private Knee Replacement?

If you have been experiencing knee pain and all other non-surgical methods are not helping, your doctor may recommend a total knee replacement. You may be wondering when is the right time for you to get it done. Although there is not a definite answer to this question, certain things have to be considered and discussed with your orthopaedic surgeon. Here are some questions to ask yourself and concerns to bring to your doctor.

  • Is your mobility severely compromised?

If you have been struggling to perform your daily physical activities such as walking, climbing stairs or simply moving around running errands and or getting to work, this could be a good indicator that surgery may be in order.

  • What is your pain level and does it stop when you rest?
  • Is your pain so severe that you have a hard time getting on with your daily routines?
  • Is your knee joint swollen?

Do you experience inflammation and swelling that does not improve after taking medications or resting?

  • Are you having restful sleep?

Do you experience lasting pain that continues while you are resting? Does it keep you up at night and prevents you from getting a good night sleep?

  • How much damage due to arthritis do you have according to the X-ray?

Your doctor should be able to help you answer this question by reviewing the X-ray with you. Severe arthritis damage can not be reversed and the pain can only be relieved by undergoing a total knee replacement

  • How old are you?

Your age matters, but should not be the deciding factor. In general, your knee implant should last 15-25 years, thus most people with arthritis only need one knee replacement in their lifetime. However, younger adults are now undergoing knee replacements and there is a chance that they will need revision surgery later on in life.

Although there is no perfect rule to timing waiting too long or going in too soon is not optimal. If you wait too long, your mobility is decreased and due to this, you may have a hard time exercising and start developing other health issues such as cardiovascular problems. There is a chance you will experience depression because you are unable to do things you once enjoyed. Another problem with delaying knee replacement surgery is that the surgery will be less effective because you will not get as much function back. However, having a total knee replacement too soon may mean that the benefits will be minimal and you may require a revision later on in life.

Bring up all your questions and concerns to your orthopaedic surgeon to discuss your options. If you were put on a long wait list and are seeking private total knee replacement we can help. Reach out to us and we will discuss your private options.

Dangers in Medical Travel

We hear the news reporting on the horrors of medical travel quite often. It is quite unsettling to read the details and understand how it became a harsh reality for someone. CDC periodically issues warning about infections being spread in other countries at the facilities that may see foreign patients. Several outbreaks of infectious disease among medical tourists have been documented. Recent examples include surgical site infections caused by nontuberculous mycobacteria in patients who underwent cosmetic surgery in the Dominican Republic and Q fever in patients who received fetal sheep cell injections in Germany. If you are planning to travel to get medical care, be assured that many medical facilities deliver successful outcomes. And even though all surgeries carry risks, there are certain steps you can take to minimize yours.

Dangers To Avoid

  • The facility does not have a US, Canadian or JCI Accreditation
  • You cannot verify the surgeon’s credentials and what they are certified to perform in, that they are up to date and what their actual training was in
  • The facility doesn’t publish their infection rate
  • There is no procedure in place if there is an emergency or something goes wrong during the operation

But It’s Cheaper

While cost is important it should not be your deciding factor.  Many people think it’s just breast implants or simple hernia surgery.  They do these every day.  What could go wrong?  If the right standards are not met, A LOT!  Sometimes you get what you pay for and your health should not be compromised to save a few dollars.

Having a safe, successful surgery should be your number 1 priority.  That can be achieved if you gather all the facts.  This can be incredibly time consuming but well worth the effort.  Hiring a Medical Facilitator that does all of this for you will ensure no detail or question is left unanswered.  It also gives you a guide through the entire process.  If you are in need of such knowledge and expertise, contact Health Vantis today!

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