Avoid obesity to lower the risk of knee replacement

Obesity is a well-recognised global epidemic. In the last 30 years, worldwide obesity has doubled. The prevalence of obesity in India is 12 to 31 per cent in various age groups. About 22 to 39 per cent Indian population suffer from osteoarthritis (OA) of the knee. The most significant impact of overweight on bone and joints is associated with degenerative OA of the knee. The treatment of end stage osteoarthritis of knee is surgical — total knee replacement (TKR). Good lifestyle incorporating a balanced diet, physical fitness and exercises lowers the risk of obesity and thus the risk of OA of the knee.

In India the risk of OA and need for total knee replacement surgery increases after the age of 50. The increasing life expectancy and increasing prevalence of obesity in our country pose a new health hazard of obese patients requiring knee replacement. Obesity during early adulthood predisposes to OA. Obesity is a leading driver of knee replacement demand and imposes increased risks of surgical complications. Obesity is the greatest modifiable risk factor for OA knee. A body mass index (BMI) of more than 30kg/m2 is 7 times more likely to develop osteoarthritis knee. The relationship of body mass index to osteoarthritis is significantly higher in women than men.

Overweight causes degeneration of joints, especially knee by not only increasing the mechanical loading of the joint but also hormonal dysregulation in the body. OA causes limitation of all aspects of the life through pain and limitation of mobility. It is estimated that the economic burden of osteoarthritis was only second to diabetes in USA, and we are not far away from this situation.

Weight reduction or maintaining healthy lifestyles such as regular exercises, walking, jogging, and sporting activities not only can keep the knee and other joints healthy but can keep the articular cartilage nourished and prevent early degeneration of the joints. Balanced diet can help in maintaining a good metabolism in the body in patients with obesity, diabetes, and cardiac illness which often coexist.

It has been proved in multiple studies that the weight reduction helps in relieving pain and improving function in patients suffering from crippling knee degenerative arthritis. The high impact exercises such as running, jogging, and treadmill are not advisable in patients, once the degeneration in the joints is already set in. The exercises for patients with knee arthritis include muscle strengthening across the knee including the quadriceps strengthening and hamstring strengthening exercises. Joint mobilisation exercises to prevent stiffness and a possible development of deformity, help in relieving the arthritic pain to a great extent.

Once the knee arthritis becomes severe, the various exercises to reduce weight and maintain active lifestyle become a challenge. Hence a good awareness of modifiable risk factors for obesity and arthritis of the knee can help us to lead a happy healthy and pain free life. Avoiding obesity by using good lifestyle, balanced diet, and exrercises not only reduces array of medical disorders (diabetes, increased cholesterol, heart disease, osteoporosis, etc) but also significantly reduces the risk of OA knee, and thus, the need for knee replacement surgery.