Obese patients sometimes denied repla...

Obese patients sometimes denied replacements for knees, hips

There are 56 comments on the Birmingham News Online story from Mar 6, 2006, titled Obese patients sometimes denied replacements for knees, hips. In it, Birmingham News Online reports that:

As demand for knee and hip replacements grows, many surgeons are turning away some patients who need the procedures most: the overweight and the obese.

Join the discussion below, or Read more at Birmingham News Online.

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Mrs T Brown


#1 May 11, 2006
I'm obese.That out of the way lets start.My hip condition started in my thirties(I'm now 53)stiffness when rising ect.My family are all with little excpection large/obese, but I'm the first to my knowledge who has needed a hip o/p.My relatives live into there 80's my maternal grandfather to 100 and obese.Without surgery I will before too long be disabled,I can no longer get into the drivers seat without dragging my foot the length of the car door, as I can no longer lift or draw up towards my chest to get in to drive,I also have grave dificulty if its not possible to open my door fully.I accept it will be more difficult mobility wise post o/p,but do not beleive any worse than the life I face without surgery.Toni Brown.
Would our goverment(+ national health)prefer that I leave my job and claim invalidty,as this maybe the route I'll be forced down.

Montréal, Canada

#3 Jun 19, 2006
I am overweight also. I finally found a Dr. that would do the surgery. He said it might be a little harder on me with a little more risk but it would not make his job any harder. I was treated very rudely by several doctors because of my weight. One dr. said "you're overweight and don't want to help yourself, I'm not going to help you." One doctor suggested that I take up smoking since I had a weight problem (I had gone in for chest pains). I am getting around better since the total hip replacement 10 days ago. Keep looking for a doctor that will help you. There has to be one out there somewhere. Take care and good luck


#4 Jul 23, 2006
At what weight were you?I weight 245, I need a knee replacement. Do you think I will be deined

Montréal, Canada

#5 Jul 23, 2006
I was at 250. It is hard to lose the weight when you can't move around. I'm sure you can find a doctor that can help you. I know they prefer that you lose weight and being heavier there is more risk. It has been 6 1/2 weeks since my surgery and I feel really good - at least on the hip that has been taken care of. The other one hurts like heck and I will have that one done in October.
Missouri Gal

Blue Springs, MO

#6 Mar 13, 2007
I have not been denied, but my orthopedic definately wants me to lose weight before knee replacement surgery.

I appreciate his feedback on this, but I am not sure he understands how difficult that is when you are in constant and severe pain. I need both knees replaced and now due to the way I walk, my achilles tendon is ruptured and I am in a cast in one leg and of course the other tendons are terribly sore in the other leg...something of which has been going on for a year. He believes it was due to my knees.

I have lost about 30 pounds and am struggling to lose more. I probably need to lose at least another 50 to 100 pounds before he would think it was safe. He just feels it leads to more infection chances and that my weight will shorten the wear time on the joint.

My thought is, well, this quality of life has definately shortened my time already. Definately the quality is disturbing.

I take complete responsibility for my weight. One would think with all this, I would be so motivated to lose weight, yet I struggle.


#7 Mar 21, 2007
I am over weight and they did my partial knee and I am having the other knee done soon. I do agree though it would be less stressful on the knee if I loose weight. I will try once agin to do so .

Riverside, CA

#8 Jul 23, 2007
I too am severely overweight and need a hip replacement. My doctor said it needs to be done within the year but wants me to lose weight first. I have taken up swimming to help me with the exercise I need and have lost 17 lbs thus far. The pain that I'm in due to my hip is the motivation I needed to start living a healthier lifestyle.

Collinsville, IL

#9 Jul 23, 2007
ALso, if a patient is obese, and has this type of surgery, there are far more greater risks involved during and after the surgery. Blood clots, strokes, pneumonia, infection, failure of appliance to work or unable to stand the stress of the individual's weight etc. It's not a discriminatory thing, it has to do with what's the safest thing for the patient. Losing weight is one of the hardest things to do. I know, I fight that battle everyday. Good luck to all who have their surgery and follow your doc's instructions for a safe and healthy recovery.

United States

#10 Jul 29, 2007
The weight above your knee is important to watch. I have recently had a total knee replacement and was told each pound is worth 3 pounds of torque on my knee. I am not fat, I am an old body builder sports finatic who weighs 295 pounds. Our knees dont care if we are fat or in shape, they just say "ouch" at all of the weight above them. A doctor should also treat a heavy person, muscular or obese the same.I was warned with my weight I must always be careful and rehab took longer than most. In fact I still am at it after almost 9 weeks. I am trying to lose and I encourage everyone to do it for all health reasons. Mean doctors don't deserve to get your money or deserve to hurt your heart and mind. Good luck finding the right doctor and may we all enjoy the days without pain some day.

Since: Aug 07

Huntersville, NC

#11 Aug 14, 2007
Many doctors do not want to do surgery on patients who are "morbidly" obese for several reasons. One reason is because the obesity is a main contributing factor to the problems in the first place. Doing surgery will do little to help if the patient is willing to little or nothing about their weight. Second, there are many risk factors in patients who are morbidly obese. Many have hypertension, heart problems, and diabetes. The risks of losing a patient outweighs the benefits of the surgery. The risks of infection postoperatively are also much greater. Many joint replacement surgeries require extensive rehab postop which would make this more difficult in an extremely overweight person. Many doctors are offering assistance to their patients by guiding them in the right direction for help in weight loss, i.e. nutritionists, gastrointestinal physicians for gastric bypass, and aquatic pool therapy which assists in helping the present condition plus shed a few pounds.

United States

#12 Apr 14, 2011
Sorry, Barbee, but you are wrong. I have acetabular dysplasia aka "hip dysplasia" and that condition has nothing to do with weight--it is a defect of the bone. Nothing that I can do in terms of weight will help or hinder the condition. Many people getting THR have this condition and it is the reason their hip is degrading. As a matter of fact, when I was researching treatment for it and reading up on THR I learned that while our society THINKS that carrying extra weight makes the dysplastic hip degenerate faster and makes regular hips degenerate faster, statistics on the people having surgeries show that it is not true. Sorry I don't have a link to that scientfic article, but it is true.

I totally agree that someone who is overweight/obese should do everything they can to lose weight to make the surgery and recovery easier-- as long as it is healthy things they are doing. Having gastric bypass surgery is a money maker for dr's and hospitals but it is not healthy nor does it actually help people lose weight. Eating less and exercising more does the trick.

Wheaton, IL

#14 Apr 19, 2011
I just went to a top surgeon in Chicago yesterday after going to a more local suburban surgeon a year ago. The first surgeon said "self help", loose weight, take up swimming and take glucosamine. He did not even mention any kind of shots. Well a year later nothing has changed. I went to a top surgeon yesterday and the issue of weight never even came up. I'm tall so I hide my weight somewhat but I am way overweight. He told me nothing would help me walk without pain except knee replacements which I pretty much knew. He pooh poohed shots as ineffective and temporary if helping at all in my case. I'm going to his partner tomorrow and going to schedule surgery to replace my left knee tomorrow. Don't give up.

Palo Alto, CA

#15 May 16, 2011
I, too, am overweight, and have faced no problems working with a doctor near San Francisco who draws patients from all over the world. He hasn't even mentioned my weight, much less deny surgery because of it. Well, it makes sense. If I need to lose weight, as I do, then I can best do it when I can exercise. If you're denied surgery because of your weight, don't be disheartened. Just look further in the medical world. You'll find a good orthopedic surgeon.

Chula Vista, CA

#16 May 16, 2011
I am 350 and got accepted. I had to force my Osteo to run it forward to the surgeon. When he saw the XRAYS he scheduled the appointment, no problem. Be forceful

Ocala, FL

#17 Sep 22, 2011
Well, today is my husband's 45th birthday, and he weighs 343 lbs. When he was 17, his right hip was fused, thus leaving him with one hip. It is expected, according to the research I have done on hip fusions, to have lower disk problems and eventual problems in the other hip joint over time. This has happened. He has been going to the original surgeons son, who is in the same practice now in Gainesville, FL. This dr REFUSES to do the surgery until he is down to 250. His hip has failed and he has fallen a few times. He is now on a walker. UNBELIEVABLE! We still have so much life to live, and have a 12 year old daughter. He has lost 23 lbs since his first visit, is in extreme pain, which I'm sure you all know how it feels. The dr will not budge. "See the pain mgmt dr" they say. They also gave me the phone number for Shands in Gville, who, will also not do the surgery. We have an appt with a surgeon in Ocala, who we hope will consider it. If not, my husband is looking at going on disability. Just had an xray done Tuesday...absolutely NO space in the joint. Totally gone. I just cant believe no one will help! Wish us luck.

Winter Park, FL

#18 Sep 22, 2011
No I'm 250 and scheduled for Nov 14 , have exercises to do before to strenghen muscles in arms and legs.
princess wrote:
At what weight were you?I weight 245, I need a knee replacement. Do you think I will be deined

San Jose, CA

#19 Oct 28, 2011
I think it has to do with things will not do better if one is obese and it will the person will just not get better. In fact, it might be worse than what I read here http://www.depuypinnaclelawsuit.com/recall
Jane Cordell

Berkeley, CA

#20 Jun 13, 2013
I have Kaiser and have spoken to 3 orthopedic surgeons. Each has said to lose weight.(Female, 6', 265) I have lost about 15 pounds since my first conversation. The second said "20-30 good faith pounds," the others said the more, the better. The 3rd said I would have a high risk surgery (and hindered recovery) if I had surgery now.

I was hurt the first two times, and now I get it... BUT, I struggle with weight loss. Third surgeon suggested weight loss surgery! But I thought I was high risk for surgery?!

Got the hip injection today. Hoping for a miracle...

Wishing you all pain-free futures with or without your big, beautiful bodies!

Owasso, OK

#21 Jan 29, 2014
Larry wrote:
I am 350 and got accepted. I had to force my Osteo to run it forward to the surgeon. When he saw the XRAYS he scheduled the appointment, no problem. Be forceful
Did you have your surgery and if so what was the outcome, I'm at 315 lbs and scheduled for surgery Feb 13th
big ray

Ocala, FL

#22 Feb 3, 2014
Larry wrote:
I am 350 and got accepted. I had to force my Osteo to run it forward to the surgeon. When he saw the XRAYS he scheduled the appointment, no problem. Be forceful
sounds like me......I'm in Ocala, fl and 2-surgeons have said to lose weight first... hard to do if your bedridden... I did lose 60 pounds in the year up to when I could no longer walk... help anybody....

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