Abstract
As defined by body mass index (body weight in kilograms divided by height in meters squared) one out of three Americans is “overweight”. The excuses and reasons for this situation are genetic, dietary, cultural, and physiologic – occasionally related to the severity of arthritis, which precludes normal activity. Scandinavian literature has shown a higher incidence of gonarthrosis in obese patients as well as some indication of decremental surgical results. Patient selection requires identification of the distribution of the obesity and its implications for knee surgery. Anaesthetic techniques should stress regional approaches, oxygenation, and modified postoperative regimens. Surgical incisions should be midline, longer than normal, and involve eversion of the patella within its fat envelope. Increased tourniquet length as well as width is mandatory. Wound complications are certainly more common, while the overall statistics from knee arthroplasty in the obese are not discouraging. Greater pressure is placed on the surgeon to achieve perfect alignment and balance, less the patient’s weight unmask the imperfections of the arthroplasty. Sadly, only 18% of people lose weight after joint replacement.
The abstracts were prepared by Mrs Dorothy L. Granchi, Course Coordinator. Correspondence should be addressed to her at PMB 295, 8000 Plaza Boulevard, Mentor, Ohio 44060, USA.
