Bariatric Surgeon India

Obesity With Knee Pains – What Surgery First?

Obesity or being overweight are considered to be the fifth most common risk factors for death worldwide. At least 2.8 million adults die each year from chronic obesity, in both developed and developing countries. Morbid obesity is associated with several comorbidities that can seriously affect the patient’s health. These include diabetes, dyslipidemia, obstructive sleep apnea, high blood pressure and pain in the knee joints and back. However, the combination of obesity and diabetes has increased alarmingly in recent years and has become a common problem worldwide. According to the World Health Organization (WHO), people with a body mass index (BMI) of more than 30 kg / m2 are overweight, and people over 35 kg / m2 are considered obese.

Obesity is one of the significant risk factors and most modifiable for developing osteoarthritis (OA). It is a progressive degenerative disorder that causes joint damage, chronic pain, muscle atrophy, reduced mobility, low balance and ultimately, physical impairment. Arthritis is becoming a global pandemic, and its presence in obesity and diabetes is more common than ever. The prevalence of OA in India is believed to be between 17% and 60.6%. People with clinically determined obesity (BMI> 30 kg / m2) are four times more likely to have knee OA than people with normal BMI (<25 kg / m2). 

For troubled knees, being overweight is just as bad as getting older. This article is provided by Dr Venu Gopal Pareek, which gives information about obesity and knee pains.

 Knee pain

Walking up and down the stairs is often a burden for chronic knee pain. It’s quite noticeable at any age and can be worse and common in obese people. This could be the result of pressure on weight-bearing joints,  inactivity and muscle weakness. Obesity complicates this condition because the front knee structure, including the patella, needs five times stronger than our weight. By focusing on losing weight, knee pain can often be relieved by non-surgical procedures. 

Symptoms of the knee with obesity:

• Pain in the knee at the front of the knee during and after an activity,
• Increased pain when resuming activity after prolonged sitting
• Swelling, numbness, or limited mobility
• Feeling unstable, usually when walking
• Pain when squatting, climbing and descending stairs

How does being overweight harm your knees?

Being overweight puts pressure on our knees in three different ways:

• Mechanical stress: The constant pressure of being overweight causes the joints to work harder and causes tension. Although “strength training” such as walking and lifting weights help strengthen bones, carrying extra weight is harmful to your body.
• Biomechanical stress: Being overweight puts pressure on the cells in the knee joint, which must send signals to the body for cell growth. If you are overweight, these cells don’t send the correct signal, and the cells in the knee joint are not repaired.
• Fat is not just stored energy waiting to be used, but it also communicates with the body. For example, adipose tissue sends messages that affect how the body works. Cellular signalling proteins called adipokines slow blood vessel growth and cause knee joint damage and pain.

When the fat starts working, the cartilage at the end of our bones will weaken, and the bone scratches the bone. This type of damage is known as osteoarthritis, which is different from rheumatoid arthritis. Patients with knee osteoarthritis find walking and most types of exercise (other than swimming) more painful. As a result, they become less active and gain weight, making their knee joints even worse! It’s a vicious cycle, so it’s no wonder patients with osteoarthritis report a lower quality of life and even more obese patients, so their doctors recommend knee surgery.

Treatments for knee pain:

Depending on your history and physical examination, doctors usually recommend an upright X-ray to assess the extent of arthritis in your knee as you put weight on your joint. Unless emergency orthopaedic intervention is required, doctors usually recommend the following:

• Strengthening muscles: Your quadriceps are essential for maintaining the strength and stability of your knee joint. Doctors recommend that you start with a home exercise program and include exercises that specifically strengthen these muscles. If necessary, we can ask you to undergo a unique strengthening program with physiotherapy for several weeks.
• Weight loss: Weight loss is a critical element in reducing pain in the front of the knee. Your doctor can give you diet changes and simple recommendations when you visit their office. Suppose you have some nutritional issues or other medical conditions that require an excellent approach to weight loss. In that case, you can seek advice from a nutritionist and, in some cases, a bariatric surgery.

Often, when it hurts during exercise, losing weight can be difficult. Exercising in the pool will reduce the stress on your joints as well as keep your muscles healthy.

• Pain control:
  • Over-the-counter pain relievers such as NSAIDs (Advil, Motrin, Aleve, Ibuprofen, Naproxen), Tylenol
  • Ice, high, with soft knee braces
  • With a stick or walking stick
• Surgical Options: Here, the main things come obesity with knee pains-what surgery first.

If you have arthritis in your knee and wonder whether to replace your knee, doctors do not recommend surgery if your Body Mass Index (BMI) is greater than 35 or 40. The risk of infection increases dramatically in patients with a higher BMI. A BMI of more than 40 and the risk of surgery, including infection, stroke, heart attack, and even death, continue to increase, and surgeons’ technical ability to perform procedures is compromised. Doctors don’t want you to be exposed to this risk, and they recommend weight loss through diet or perhaps bariatric surgery for those who fail the diet test.

Knee replacement before weight loss surgery Observation:

• Knee pain is reduced, and the patient can walk freely.
• One can add the benefits of walking, but postoperative physiotherapy is very difficult.
• During anaesthesia, there is a higher risk of comorbidities. Surgery can be more difficult because of the buildup of excess fat around the knees and thighs. One needs special care to minimize wound infection or delayed healing because fat has low healing properties.
• Associated conditions in this patient such as diabetes, blood pressure, difficulty breathing contribute to difficulties before and after joint replacement.

Bariatric surgery before joint and knee replacement Observation

• Weight loss surgery offers various benefits such as weight loss, reversing or controlling diabetes, blood pressure and shortness of breath.
• The patient’s pain is also significantly reduced by losing weight and relieving pressure on the joints. For many patients, the pain goes away completely, without knee replacement.
• After knee and joint surgery, your movement to the recommended physiotherapy exercises also becomes easy.

 However, when joints are replaced after bariatric surgery and obesity surgery, surgery is more comfortable, and diabetes control reduces infection risk.

Conclusion:

If you are overweight or obese and have knee pain, diet and exercise changes can relieve pain and help you avoid or delay surgery. Surgery is not a “quick fix”. Remember that extra weight puts extra stress on your knee, whether it’s a knee you are born with or an artificial one. Even after a knee replacement, being overweight or inactivity creates problems that require more operations which will likely be worse than the initial knee replacement. For best bariatric surgery with knee pain contact Dr Venu Gopal Pareek at 091777 77715.