SURGICAL CANDIDACY OR WEIGHT STIGMA? THE DILEMMA OF OBESE PATIENTS IN ORTHOPAEDICS – A SYSTEMATIC REVIEW OF THE LITERATURE

Aleksandra Borowy; Wiktoria Suchcicka; Aleksandra Chajnowska; Julia Guzowska; Patrycja Rzeźnik; Maciej Sobczyk; Weronika Stachera; Julia Stępień; Barbara Wołoszyn; Małgorzata Zach

doi:10.31435/ijitss.3(47).2025.3845

Aleksandra Borowy Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland https://orcid.org/0009-0001-5542-3225
Wiktoria Suchcicka National Medical Institute of the Ministry of the Interior and Administration, Wołoska 137, 02-507 Warszawa, Poland https://orcid.org/0009-0006-8090-4852
Aleksandra Chajnowska Independent Public Healthcare Center No. 1 in Rzeszów, Rycerska 4, 35-241 Rzeszów, Poland https://orcid.org/0009-0003-2826-2926
Julia Guzowska District Medical Centre in Grójec, Piotra Skargi 10, 05-600 Grójec, Poland https://orcid.org/0009-0004-3515-121X
Patrycja Rzeźnik Independent Public Health Care Facility – A Complex of Facilities in Maków Mazowiecki, Witosa 2, 06-200 Maków Mazowiecki, Poland https://orcid.org/0009-0002-9206-7300
Maciej Sobczyk Medical University of Lublin, 1 Racławickie St., 20-059 Lublin, Poland https://orcid.org/0009-0004-1810-5916
Weronika Stachera Medical University of Lublin, 1 Racławickie St., 20-059 Lublin, Poland https://orcid.org/0009-0003-9927-0667
Julia Stępień Medical University of Lublin, 1 Racławickie St., 20-059 Lublin, Poland https://orcid.org/0009-0000-6113-9581
Barbara Wołoszyn Independent Public Health Care Facility – A Complex of Facilities in Maków Mazowiecki, Witosa 2, 06-200 Maków Mazowiecki, Poland https://orcid.org/0009-0009-0386-1205
Małgorzata Zach University Clinical Hospital named after Fryderyk Chopin in Rzeszów, Szopena St. 2, 35-055 Rzeszów, Poland https://orcid.org/0009-0006-8061-9613

DOI: https://doi.org/10.31435/ijitss.3(47).2025.3845

Keywords: Obesity, Surgery, Knee Arthroplasty, Hip, Upper Extremity, Orthopedic

Abstract

Introduction: Obesity (BMI ≥ 30) is a rapidly growing global health issue with significant implications for orthopedic health. It contributes to joint degeneration and complicates surgical treatment through both biomechanical strain and systemic inflammation, particularly affecting the hip, knee, and upper extremities.

Aim: This systematic review aims to evaluate the impact of obesity on orthopedic disorders and surgical outcomes and to assess the validity of excluding patients from surgery based solely on BMI criteria.

State of Knowledge: Obesity significantly increases the risk of postoperative complications, including infections, reoperations, technical difficulties, and inferior functional recovery. Hip and knee arthroplasties in obese patients often yield less optimal results compared to non-obese individuals, though the overall benefit remains considerable. In the upper limbs, obesity is linked to poorer outcomes in rotator cuff repair and higher incidence of compression neuropathies. Despite these challenges, many obese patients report substantial improvements post-surgery. Denying surgery based solely on BMI is not consistently supported by current evidence and may exacerbate health inequalities. Bariatric surgery shows promise in mitigating some orthopedic complications and may improve outcomes.

Conclusions: Obesity adversely affects surgical outcomes in orthopedics, but BMI should not be the sole determinant in surgical eligibility. A more individualized, evidence-based approach—emphasizing preoperative weight management and equitable access—is essential for optimal care and outcomes.

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SURGICAL CANDIDACY OR WEIGHT STIGMA? THE DILEMMA OF OBESE PATIENTS IN ORTHOPAEDICS – A SYSTEMATIC REVIEW OF THE LITERATURE

Abstract

References

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