1. Happiness is Happy Knees
Osteoarthritis and Obesity
DR.A.V.GURAVA REDDY
D. Orth, DNB Orth, FRCS (Edin), FRCS (Glas), M.Ch Orth (Liverpool)
CEO & MANAGING DIRECTOR
CHIEF JOINT REPLACEMENT SURGEON
SUNSHINE HOSPITALS
SECUNDERABAD

2. Obesity……
present day epidemic

3. How common is obesity???
• 2/3 adults and 1/3 of children are obese
• Three times more than 20 years ago
• It is an established risk factor for many diseases
• It costs 3 billion pounds per year to UK

4. Obese people think…….
Painful and disabling
disease an inevitable
consequence of ageing at
least for people who have
the wrong genes.

5. Osteoarthritis and Obesity
What you need to know??
• New research shows that the obese are up to four
times as likely to develop knee osteoarthritis as
they are to develop high blood pressure or type-2
diabetes.

6. How common is osteoarthritis
• OA is most common form of arthritis.
• Increase to be substantial in next 20
years
• >1 million people visit their GP in a
year due to OA.
• Its twice prevalent than HTN and DM.

7. Osteoarthritis
of the knee is the
most prevalent form
of large joint OA
in the world.

8. Knee X-ray At Various stages
Normal
Stage IV
Stage III

10. Osteoporosis is not
same as Osteoarthritis

11. Effects of obesity on patients
• The danger to health and quality of life is
insidious
– at every stage,
– excess body weight both increases the level of
pain and disability
– and undermines the efficacy of treatment.
• HTN and DM can be controlled with weight loss
but osteoarthritis is irreversible.

12. Obesity and osteoarthritis
How is the damage done ??
• Excessive loading of the joint ---
--obesity causes osteoarthritis.
• It is in the weight-bearing joints
- the knee and to a lesser extent
the hips
• Because of the way the knee
joint works, the effect of excess
weight can be four or five times
greater
• Poor posture and unhealthy gait
are more common in obese
people,

13. Something about osteoarthritis
• Osteoarthritis is the most common disease
affecting the joints of the body, particularly
the knees and hips.
• It is estimated that over 6 million people
over the age of 45 years in the UK have
painful osteoarthritis in their knees

14. DOES EVERYBODY
GET ARTHRITIS OF
KNEES?

17. WHAT ARE THE
SYMPTOMS?
1. PAIN
2. MORNING STIFFNESS
3. SWELLING
4. CREAKING SOUNDS
5. DIFFICULTY IN SQUATTING
6. DIFFICULTY IN STAIRS

18. The most significant symptom is an
aching, sharp or burning pain that is made
worse with activity.
Eventually, the cartilage wears away
completely ,worsening the pain and
causing difficulty in movement
However, of preventable factors,
obesity is far and away the single
biggest cause of osteoarthritis in
weight-bearing joints.
The earlier someone becomes overweight
or obese, the greater the risk of
developing osteoarthritis.

19. CAN WE PREVENT
OA?
NO, BUT WE CAN
DELAY OR SLOW
DOWN THE
PROCESS

20. • Once entrenched, osteoarthritis is likely to have the effect of further reducing
activity, bringing about increased weight gain.
• As well as worsening osteoarthritis symptoms, this further increase in weight
will also raise the risk of developing other obesity-related diseases.
Obesity
Increased
Weight
Early
Osteoarthritis
Reduced
Activity

21. Obesity and Osteoarthritis –
The need for surgery
• As well as causing osteoarthritis to develop, persistent
obesity increases the level of pain and disability while
reducing the efficacy of pain-relieving drugs.
• 2/ 3 TKR & ¼ THR IS DUE TO OBESITY

22. Obesity
The bad news for surgery outcome
• Knee and hip replacements are among the great
success stories of modern surgery.
• Research shows that nearly 50 per cent of obese
patients have a poor outcome from joint replacement
surgery compared to less than ten per cent of those
with a healthy weight.

23. 120 kg weight when he got operated

24. Bow legs in obesity

25. •WHAT EXERCISE IS
GOOD??
•IS CYCLING /
TREADMILL GOOD?
•ANY DIET
RESTRICTIONS?

26. WHAT SHOULD I DO?
1.KEEP FIT
2.KEEP YOUR WEIGHT
DOWN
3.NO SQUATTING
4.MINIMIZE STAIRS

27. Prevention is the best Medicine
• Benefits of a healthy weight
– Achieving a healthy weight reduces the risk of developing
the disease in the first place, relieves existing symptoms
and helps to prevent further deterioration.
• There is increasing evidence that exercise is most effective
in reducing both pain and mobility when combined with
weight loss.

28. Bariatric surgery can be
helpful in such patients to give
better results of
TKR and THR

29. Last Resort is TKR
Am I slim enough to get TKR??

30. Thank “u”