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वजन, मोटापा और जोड़ों का स्वास्थ्य

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How body weight and obesity affect joint load, osteoarthritis, and the risks and outcomes of joint surgery — including the role of weight loss before an operation.

Updated Sep 2026
बाथरूम का वजन।
अधिक वजन जोड़ों पर बोझ डालता है और सर्जिकल जोखिम बढ़ाता है; यहां तक कि मामूली हानि भी लक्षणों को कम कर सकती है और परिणामों में सुधार कर सकती है। Kieran Hirpara 4.0

यह पृष्ठ मशीन द्वारा अनूदित है और अभी तक किसी चिकित्सक द्वारा जाँचा नहीं गया है। अंग्रेज़ी संस्करण ही आधिकारिक है।

यह क्या है

वजन और जोड़ों का स्वास्थ्य निकटता से जुड़े हुए हैं। अतिरिक्त वजन उठाना आपके घुटनों से ज्यादा प्रभावित करता है। मोटापा एक संपूर्ण शरीर की स्थिति है जो सूजन का कारण बनती है, और यह सूजन आपके जोड़ों तक भी पहुंचती है [1]. यह केवल आपके जोड़ों द्वारा प्रतिदिन उठाए जाने वाले अतिरिक्त बोझ के बारे में नहीं है।

एक उच्च बीएमआई आपके घुटनों और हाथों में पहनने और आंसू गठिया (ओस्टियोआर्थराइटिस) के जोखिम को बढ़ाता है, यहां तक कि उन लोगों में भी जो अन्यथा स्वस्थ हैं [2]. आपके बीच में जमा वसा (मध्य मोटापा) भी कंधे के जोड़ में गठिया के साथ जुड़ा हुआ है [3]. यदि आप जोड़ों की सर्जरी पर विचार कर रहे हैं, तो वजन उन चीजों में से एक है जिसके बारे में आपका डॉक्टर आपसे बात करेगा।

जिस तरह से वजन और गतिविधि एक साथ काम करते हैं, उसे बहुत से लोग अच्छी तरह से नहीं समझते हैं। मोटापे का कारण शारीरिक निष्क्रियता की तुलना में आहार पर अधिक ध्यान दिया गया है [4]. आंदोलन मायने रखता है। फिट रहना आपके दिल और समग्र स्वास्थ्य की रक्षा करता है, और यह अतिरिक्त वजन के साथ आने वाले कुछ जोखिमों को कम करता है [5]. सप्ताह में लगभग 30 से 35 मिनट की छोटी मात्रा में जोरदार गतिविधि भी पेट के मोटापे और हृदय रोग के बीच के संबंध को कम करती है [6].

वजन कुछ ऐसा है जिसे आप बदल सकते हैं। मोटापे से निपटने से बच्चों सहित संयुक्त स्वास्थ्य और समग्र स्वास्थ्य में सुधार हो सकता है [7]. यदि आप संयुक्त प्रतिस्थापन सर्जरी के लिए तैयारी कर रहे हैं, तो अपने वजन और अन्य स्वास्थ्य स्थितियों को पहले से नियंत्रित करने से सामान्य बीएमआई वाले रोगियों के समान परिणाम हो सकते हैं [8].

क्या यह काम करता है?

ईमानदार जवाब यह है कि यह इस बात पर निर्भर करता है कि "यह" क्या है। वजन घटाने के लिए, सर्जरी सीधे घुटने के प्रतिस्थापन के लिए जाने से बेहतर काम करती है जब किसी को गंभीर मोटापा और उन्नत गठिया है। एक अध्ययन में, जिन लोगों ने वजन घटाने की सर्जरी की थी, उन्होंने अपने शरीर के वजन का 28.7% खो दिया, जबकि जिन लोगों ने घुटने की प्रतिस्थापन की थी, उन्होंने तुरंत कम खो दिया [1]. नई वज़न घटाने वाली दवाएं एक और विकल्प हैं। एक अध्ययन में पाया गया कि सेमग्लुटाइड नामक दवा हिप प्रतिस्थापन से पहले वजन घटाने की सर्जरी के लिए एक सुरक्षित विकल्प थी, जिसमें समान प्रत्यारोपण अस्तित्व और जटिलता दर थी [2].

जब संयुक्त प्रतिस्थापन सर्जरी की बात आती है, तो तस्वीर कई लोगों की अपेक्षा से अधिक मिश्रित होती है। उच्च बीएमआई होने का अर्थ स्वचालित रूप से खराब परिणाम नहीं है। अध्ययनों से पता चला है कि 40 से अधिक बीएमआई घुटने के प्रतिस्थापन में प्रारंभिक जटिलताओं के साथ जुड़ा नहीं था जब अन्य स्वास्थ्य स्थितियों को पहले प्रबंधित किया गया था और योजना रोगी के अनुरूप थी [3]. हिप प्रतिस्थापन अध्ययनों में पाया गया कि मोटापे की गंभीरता ने आगे के ऑपरेशन के जोखिम, आक्रामकता या समय को नहीं बदला [4]. कंधे के प्रतिस्थापन के अध्ययन में पाया गया कि बीएमआई संशोधन सर्जरी की आवश्यकता के उच्च जोखिम के साथ जुड़ा नहीं था [5]. दूसरी ओर, कुछ अध्ययनों में अधिक जोखिम पाए गए। सामान्य वजन वाले लोगों की तुलना में मोटापे से ग्रस्त लोगों को बाद में पूर्ण हिप प्रतिस्थापन की आवश्यकता होने की संभावना दोगुनी से अधिक थी [6]. मोटापा भी आंशिक घुटने के प्रतिस्थापन के बाद संशोधन की आवश्यकता के जोखिम को बढ़ाता है [7].

इनमें से कुछ सबूत मज़बूत हैं और कुछ नहीं हैं। इनमें से कुछ निष्कर्ष छोटे अध्ययनों से आते हैं, इसलिए परिणाम कम निश्चित हैं। उदाहरण के लिए, एक अध्ययन ने सुझाव दिया कि 45 का बीएमआई एक प्रकार के घुटने के प्रतिस्थापन के लिए एक सुरक्षित कट-ऑफ था, लेकिन यह सुनिश्चित करने के लिए समूह बहुत छोटे थे [8]. व्यायाम भी मदद कर सकता है। कम मांसपेशी द्रव्यमान और मोटापे के संयोजन वाली महिलाएं जिन्होंने उच्च तीव्रता वाले अंतराल प्रशिक्षण किया था, वे उन लोगों की तुलना में अधिक वजन खो गईं और उनके पास कम बीएमआई था जो लगातार मध्यम व्यायाम कर रहे थे [9]. व्यायाम और वजन घटाने की दवा के संयोजन से दीर्घकालिक स्वास्थ्य में सुधार हो सकता है और वजन कम करने में मदद मिल सकती है [10].

जोखिम क्या हैं?

जोखिम इस बात पर निर्भर करता है कि आप किस ऑपरेशन के लिए जा रहे हैं। घुटने के प्रतिस्थापन के लिए, आधुनिक शल्य चिकित्सा विधियों और इम्प्लांट डिजाइनों ने मोटापे से ग्रस्त लोगों में ढीली होने और यांत्रिक विफलता के साथ पुरानी समस्याओं को कम किया है [1]. लेकिन कुछ जोखिम बने हुए हैं। मोटापा अभी भी एक प्रकार के रोबोट घुटने के प्रतिस्थापन के साथ यांत्रिक विफलता के लिए एक प्रमुख जोखिम कारक है, भले ही दिन-प्रतिदिन का कार्य बाद में समान था [2]. गंभीर मोटापे वाले लोग, 35 या उससे अधिक का बीएमआई, रोबोटिक घुटने के प्रतिस्थापन के बाद अधिक जटिलताओं की ओर रुझान दिखाया, हालांकि अंतर स्पष्ट नहीं था [3]. अगर आपके घुटने का पूरा नहीं बल्कि आंशिक प्रत्यारोपण किया गया है, तो मोटापे से दोबारा सर्जरी की ज़रूरत पड़ने की संभावना बढ़ जाती है [4].

कूल्हे और कंधे की सर्जरी के लिए, चित्र शांत है। हिप प्रतिस्थापन के बाद, आपके मोटापे की गंभीरता ने आगे के ऑपरेशन के जोखिम, आक्रामकता या समय को नहीं बदला [5]. मोटापे के शीर्ष पर टाइप 2 मधुमेह होने के कारण बीएमआई को ध्यान में रखते हुए फिर से ऑपरेशन का अतिरिक्त जोखिम नहीं था [6]. कंधे की प्रतिस्थापन के बाद, बीएमआई संशोधन सर्जरी की अधिक संभावना के साथ जुड़ा नहीं था [7], हालांकि अधिक वजन और मोटापा रक्त के थक्के के जोखिम से जुड़ा हुआ था, संक्रमण से नहीं [8].

कीहोल सर्जरी में अलग-अलग जोखिम होते हैं। अगर आपको दर्दनाक चोट के लिए कीहोल हिप सर्जरी कराई जाती है, तो मोटापा आपको बाद में पूर्ण हिप प्रतिस्थापन की आवश्यकता होने की संभावना को दोगुना कर देता है [9]. पहले से मौजूद मोटापा और गठिया भी कीहोल घुटने की सर्जरी के बाद खराब परिणाम की भविष्यवाणी करते हैं [10]. मेनिस्कस रूट की मरम्मत के बाद, उच्च बीएमआई वाले लोगों में गठिया तेजी से आगे बढ़ी [11].

कुछ निष्कर्ष कम निश्चित हैं। एक अध्ययन ने सुझाव दिया कि 45 का बीएमआई एक प्रकार के घुटने के प्रतिस्थापन के लिए एक सुरक्षित कट-ऑफ था, लेकिन यह सुनिश्चित करने के लिए समूह बहुत छोटे थे [12]. मोटापे से ग्रस्त लोगों के लिए घुटने के प्रतिस्थापन में अतिरिक्त प्रत्यारोपण समर्थन जोड़ने पर साक्ष्य सीमित और असंगत है [13]. घाव भरने के लिए सिर्फ बीएमआई की तुलना में हड्डी के ऊपर के नरम ऊतकों की मोटाई पर अधिक निर्भर करता है [14].

मोटापे से ग्रस्त बहुत कम लोगों को जोड़ों के प्रतिस्थापन से पहले दवाओं, पोषण सेवाओं या वजन घटाने की सर्जरी के माध्यम से वजन घटाने का उपचार मिलता है। [15]. जहां वजन चिंता का विषय है, यह आपके डॉक्टर के साथ पहले से चर्चा करने लायक है।

क्या यह आपके लिए सही है?

उच्च बीएमआई वाले लोगों के लिए संयुक्त प्रतिस्थापन अच्छी तरह से काम कर सकता है। अध्ययनों से पता चला है कि 40 से अधिक बीएमआई घुटने के प्रतिस्थापन में प्रारंभिक जटिलताओं से जुड़ा नहीं था [1]. हिप प्रतिस्थापन अध्ययनों में पाया गया कि आपके मोटापे की गंभीरता ने आगे की सर्जरी के जोखिम, आक्रामकता या समय को नहीं बदला है [2]. कंधे के प्रतिस्थापन के अध्ययन में पाया गया कि बीएमआई संशोधन सर्जरी की आवश्यकता की अधिक संभावना के साथ जुड़ा नहीं था [3]. इसलिए अधिक वजन अपने आप में आपको बाहर नहीं करता है।

सीमाएं हैं। एक अध्ययन ने सुझाव दिया कि 45 का बीएमआई एक प्रकार के घुटने के प्रतिस्थापन के लिए एक सुरक्षित कट-ऑफ था, लेकिन यह सुनिश्चित करने के लिए समूह बहुत छोटे थे [4]. यदि आप कीहोल हिप सर्जरी के बजाय प्रतिस्थापन पर विचार कर रहे हैं, तो मोटापा आपको बाद में पूर्ण हिप प्रतिस्थापन की आवश्यकता होने की संभावना को दोगुना से अधिक कर देता है [5]. सर्जरी से पहले वजन कम करना एक और रास्ता है। हिप प्रतिस्थापन से पहले वजन घटाने की सर्जरी के लिए एक सुरक्षित विकल्प के रूप में सेमग्लुटाइड जैसी नई दवाओं का अध्ययन किया गया है। [6]. फिर भी मोटापे से ग्रस्त बहुत कम लोगों को जोड़ों के प्रतिस्थापन से पहले दवाओं, पोषण सेवाओं या वजन घटाने की सर्जरी के माध्यम से वजन घटाने के उपचार की पेशकश की जाती है। [7].

सही विकल्प आपके वजन, आपके गठिया और आपकी अन्य स्वास्थ्य स्थितियों पर निर्भर करता है। ऊपर दिए गए जोखिम अनुभाग में बताया गया है कि प्रत्येक विकल्प के साथ क्या गलत हो सकता है। अपने डॉक्टर से इस बारे में बात करें। यह एक साझा निर्णय है, और इसे आप दोनों मिलकर लेते हैं।

निचली रेखा

अतिरिक्त वजन आपको संयुक्त सर्जरी से बाहर नहीं करता है, लेकिन यह बातचीत को बदल देता है। घुटने और कूल्हे के प्रतिस्थापन के लिए, उच्च बीएमआई अकेले अधिक प्रारंभिक समस्याओं के साथ जुड़ा नहीं था जब अन्य स्वास्थ्य स्थितियों का प्रबंधन पहले किया गया था [1]. मुख्य चेतावनी कुंजी छेद सर्जरी है: मोटापा आपको बाद में पूर्ण कूल्हे प्रतिस्थापन की आवश्यकता होने की संभावना को दोगुना से अधिक करता है [2]. सर्जरी से पहले वजन कम करना एक विकल्प है जिसके बारे में चर्चा करने लायक है, हालांकि बहुत कम लोगों को वास्तव में यह पेशकश की जाती है [3].

संदर्भ

[1] घुटने के ऑस्टियोआर्थराइटिस में मोटापे को फिर से तैयार करना: बायोमैकेनिक्स से परे एक पारस्परिक दृष्टिकोण का आह्वान। आर्थ्रोस्कोपी२०२६। डीओआईः 10.1002/arj.70051

[2] क्या चयापचय संबंधी रूप से स्वस्थ मोटापा घुटने और हाथ के ऑस्टियोआर्थराइटिस के जोखिम को बढ़ाता है? जनसंख्या आधारित कोहोर्ट अध्ययन। बीएमसी मस्कुलोस्केलेटल विकार२०२६। डीओआईः 10.1186/s12891-026-09495-5

[3] केंद्रीय मोटापा और ग्लेनहोमेरल संयुक्त ऑस्टियोआर्थराइटिस के जोखिम के बीच संबंधः एक भावी अध्ययन। कंधे और कोहनी सर्जरी का जर्नल२०२६। डीओआईः 10.1016/j.jse.2025.07.007

[4] शारीरिक निष्क्रियता और मोटापे के मिथक को तोड़ने का समय आ गया है: आप खराब आहार से आगे नहीं बढ़ सकते। ब्रिटिश जर्नल ऑफ स्पोर्ट्स मेडिसिन2015 में। डीओआईः 10.1136/bjsports-2015-094911

[5] कार्डियोरेस्पिरेटरी फिटनेस, बॉडी मास इंडेक्स और मृत्यु दर: एक व्यवस्थित समीक्षा और मेटा-विश्लेषण। ब्रिटिश जर्नल ऑफ स्पोर्ट्स मेडिसिन. 2024. डीओआईः 10.1136/bjsports-2024-108748

[6] डिवाइस-मापी गई शारीरिक गतिविधि और पेट के मोटापे के संयुक्त संघ घटना हृदय रोग के साथः एक संभावित समूह अध्ययन। ब्रिटिश जर्नल ऑफ स्पोर्ट्स मेडिसिन. 2023. डीओआईः 10.1136/bjsports-2023-107252

[7] बाल ऑर्थोपेडिक्स में मोटापे की भूमिका। JAAOS: वैश्विक अनुसंधान और समीक्षावर्ष 2019 डीओआईः 10.5435/jaaosglobal-d-19-00036

[8] बॉडी मास इंडेक्स > 40 एक एम्बुलेटरी सर्जिकल सेंटर में प्राथमिक कुल संयुक्त आर्थ्रोप्लास्टी से गुजरने वाले रोगियों में प्रारंभिक जटिलताओं के साथ सहसंबंधित नहीं है। द जर्नल ऑफ आर्थ्रोप्लास्टी२०२६। डीओआईः 10.1016/j.arth.2025.08.065

[9] गंभीर मोटापे और उन्नत घुटने के ऑस्टियोआर्थराइटिस वाले रोगियों के बीच घुटने के कार्य पर तत्काल कुल घुटने के आर्थ्रोप्लास्टी बनाम पूर्व बैरियाट्रिक सर्जरी का प्रभाव: द स्विफ्ट ट्रायल। द जर्नल ऑफ आर्थ्रोप्लास्टी२०२६। डीओआईः 10.1016/j.arth.2026.05.033

[10] क्या सेमाग्लुटाइड कुल हिप आर्थ्रोप्लास्टी (टीएचए) से गुजरने वाले रोगियों के लिए बैरियाट्रिक सर्जरी की तुलना में एक सुरक्षित वजन प्रबंधन विकल्प है? द जर्नल ऑफ आर्थ्रोप्लास्टी२०२६। डीओआईः 10.1016/j.arth.2025.08.068

[11] मोटापे की श्रेणी कुल हिप आर्थ्रोप्लास्टी के बाद पुनः संचालन की घटना, समय या आक्रामकता के साथ संबद्ध नहीं है। द जर्नल ऑफ आर्थ्रोप्लास्टी२०२६। डीओआईः 10.1016/j.arth.2025.07.026

[12] मोटापे से ग्रस्त और नॉन-मोटापे से ग्रस्त कुल कंधे के आर्थ्रोप्लास्टी रोगियों के बीच संशोधन दरः एक ऑस्ट्रेलियाई रजिस्ट्री डेटा अध्ययन। कंधे और कोहनी सर्जरी का जर्नल२०२६। डीओआईः 10.1016/j.jse.2025.05.036

[13] सामान्य वजन वाले रोगियों की तुलना में फेमोरोएसेटाबुलर इम्पिगमेंट सिंड्रोम के लिए हिप आर्थ्रोस्कोपी द्वारा इलाज किए गए मोटे रोगियों में 10 साल के कार्यात्मक परिणाम और आर्थ्रोप्लास्टी के लिए रूपांतरण दर। अमेरिकन जर्नल ऑफ स्पोर्ट्स मेडिसिन२०२६। डीओआईः 10.1177/03635465251392585

[14] मोटापा यूनिकॉम्पार्टमेंटल घुटने की आर्थ्रोप्लास्टी के बाद संशोधन की उच्च दर के साथ जुड़ा हुआ है। ऑर्थोपेडिक जर्नल ऑफ स्पोर्ट्स मेडिसिन२०२६। डीओआईः 10.1177/2325967125s00336

[15] शरीर द्रव्यमान सूचकांक 45 सीमेंट रहित कुल घुटने की आर्थ्रोप्लास्टी के लिए एक सुरक्षित कट-ऑफ है। द जर्नल ऑफ आर्थ्रोप्लास्टी2025 तक। डीओआईः 10.1016/j.arth.2025.12.038

[16] उच्च तीव्रता अंतराल प्रशिक्षण बनाम मध्यम तीव्रता निरंतर प्रशिक्षण के प्रभाव शारीरिक और चयापचय परिणामों पर बल प्रशिक्षण के साथ संयुक्त सरकोपेनिक मोटापे के साथ पोस्ट- बैरिएट्रिक सर्जरी रोगियों में। बीएमसी मस्कुलोस्केलेटल विकार२०२६। डीओआईः 10.1186/s12891-026-09722-z

[17] वजन घटाने को बनाए रखने में व्यायामः वजन घटाने के अलावा स्वास्थ्य लाभ। ब्रिटिश जर्नल ऑफ स्पोर्ट्स मेडिसिन. 2021 डीओआईः 10.1136/bjsports-2021-104754

[18] मोटापा और कुल घुटने की आर्थ्रोप्लास्टी का पुनरावलोकन: आधुनिक युग में ढीलेपन और यांत्रिक विफलता पर न्यूनतम प्रभाव। द जर्नल ऑफ आर्थ्रोप्लास्टी२०२६। डीओआईः 10.1016/j.arth.2026.04.031

[19] कार्यात्मक रूप से संरेखित इमेज-आधारित रोबोटिक कुल घुटने की आर्थ्रोप्लास्टी पर उच्च बॉडी मास इंडेक्स का प्रभावः तुलनीय कार्यात्मक परिणाम लेकिन अधिक यांत्रिक विफलताएं। इसाकोस का जर्नल2025 तक। डीओआईः 10.1016/j.jisako.2025.100861

[20] रोबोट-असिस्टेड कुल घुटने के आर्थ्रोप्लास्टी परिणामों पर बॉडी मास इंडेक्स का प्रभावः एक पूर्वव्यापी समूह विश्लेषण। इसाकोस का जर्नल2025 तक। डीओआईः 10.1016/j.jisako.2025.100927

[21] टाइप 2 मधुमेह पूर्ण हिप आर्थ्रोप्लास्टी से गुजरने वाले मोटे रोगियों में पेरिप्रोस्टेटिक संयुक्त संक्रमण के अतिरिक्त जोखिम से जुड़ा नहीं है। बीएमसी मस्कुलोस्केलेटल विकार२०२६। डीओआईः 10.1186/s12891-026-09568-5

[22] थ्रोम्बोएम्बोलिज्म के जोखिम के साथ अधिक वजन और प्रीमोर्बिड मोटापे की स्थिति सहसंबद्ध है लेकिन कुल कंधे के आर्थ्रोप्लास्टी के बाद संक्रमण नहीं। कंधे और कोहनी सर्जरी का जर्नल२०२६। डीओआईः 10.1016/j.jse.2026.05.022

[23] संपादकीय टिप्पणी:

[24] मध्यवर्ती मेनिस्कस पिछली जड़ की दरार की मरम्मत समय के साथ ऑस्टियोआर्थराइटिस प्रगति को उच्च दरों के साथ उच्च शरीर द्रव्यमान सूचकांक के साथ दिखाई देती है। आर्थ्रोस्कोपी२०२६। डीओआईः 10.1002/arj.70028

[25] उत्तरः "संपादक को पत्र टिप्पणी करते हुएः 'वर्तमान साक्ष्य मोटे रोगियों के कुल घुटने के आर्थ्रोप्लास्टी में टिबियल स्टेम एक्सटेंशन के उपयोग का समर्थन नहीं करता हैः एक व्यवस्थित समीक्षा"। द जर्नल ऑफ आर्थ्रोप्लास्टी२०२६। डीओआईः 10.1016/j.arth.2025.11.056

[26] कुल घुटने की आर्थ्रोप्लास्टी में पेरिप्रोस्टेटिक संयुक्त संक्रमण की भविष्यवाणी करने में सॉफ्ट टिश्यू-टू-बोन रेश्यो बॉडी मास इंडेक्स से बेहतर हैः एक पूर्वव्यापी केस-कंट्रोल स्टडी। द जर्नल ऑफ आर्थ्रोप्लास्टी२०२६। डीओआईः 10.1016/j.arth.2025.09.022

[27] कुल संयुक्त आर्थ्रोप्लास्टी से पहले प्रीऑपरेटिव वजन घटाने और मोटापे के उपचार में असमानताएं। द जर्नल ऑफ आर्थ्रोप्लास्टी२०२६। डीओआईः 10.1016/j.arth.2026.06.021

Reviewed by Kieran Hirpara · 13 June 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Obesity is a modifiable condition, and addressing it can improve the orthopaedic and overall health of children [1].
  • Each 1-unit increase in body mass index (BMI) is associated with a 9% reduction in osteoporosis risk [2].
  • There is significant confusion regarding the relationship between energy intake, energy expenditure, and obesity, with greater attention focused on diet than on physical inactivity [3].
  • Obesity is a systemic disease with profound inflammatory consequences on joint health, extending beyond mechanical burden on the knee [5].
  • Current evidence does not support the routine use of tibial stem extensions in obese total knee arthroplasty patients due to insufficient, heterogeneous, and very low certainty data [7].
  • Increasing obesity severity is not associated with higher rates of postoperative stiffness or inferior outcomes following manipulation under anesthesia (MUA) [10].
  • Concern for stiffness alone should not serve as a categorical barrier to total knee arthroplasty (TKA) or MUA when clinically indicated [10].
  • In a cohort of obese patients who underwent total hip arthroplasty (THA), the World Health Organization (WHO) obesity class was not associated with the risk, invasiveness, or timing of reoperations [15].
  • Obese and overweight patients converted to total hip arthroplasty (THA) at significantly higher rates compared with normal-weight patients following hip arthroscopy for femoroacetabular impingement syndrome [16].
  • The ten-year functional outcomes and revision rates of total hip arthroplasty (THA) do not justify restricting access to surgery on the basis of body mass index (BMI) [28].

How It Works

Systemic and Metabolic Mechanisms

  • Obesity is a systemic disease with profound inflammatory consequences on joint health [5].
  • Each 1-unit increase in BMI is associated with a 9% reduction in osteoporosis risk [2].
  • There is confusion regarding the relation of energy intake and energy expenditure to obesity, with more attention focused on diet than on physical inactivity [3].

Biomechanical and Structural Factors

  • Following medial meniscus posterior root tear repair, osteoarthritis progression occurs at higher rates with elevated BMI [20].
  • Obesity remains a critical risk factor for mechanical failures in functionally aligned image-based robotic total knee arthroplasty [14].
  • Modern surgical practices and implant designs may have mitigated traditional obesity-related risks regarding loosening and mechanical failure in total knee arthroplasty [11].

Surgical Outcomes and Complications

  • In patients undergoing primary total joint arthroplasty at an ambulatory surgical center, a BMI > 40 is not correlated with early complications [6].
  • Focusing on management of preoperative comorbidities and custom surgical planning can achieve outcomes comparable to those of patients with normal BMIs at ambulatory surgical centers [6].
  • Increasing obesity severity is not associated with higher rates of postoperative stiffness or inferior outcomes following manipulation under anesthesia for total knee arthroplasty [10].
  • No significant differences were observed between above-average and below-average BMI groups in clinical improvements following arthroscopically assisted posterior latissimus dorsi tendon transfer for irreparable posterosuperior rotator cuff tears [9].
  • A nonsignificant trend toward a higher complication rate was observed in patients with severe obesity (BMI ≥35 kg/m2) undergoing robotic-assisted total knee arthroplasty [22].
  • A statistically significant increase in arthrofibrosis was found in patients with BMI <25 kg/m2 undergoing robotic-assisted total knee arthroplasty [22].
  • The numbers were too small to draw conclusions in patients who have a BMI ≥ 45 undergoing cementless total knee arthroplasty [4].

Risk Stratification and Measurement

  • Body mass index has a weak-to-moderate association with peri-incisional adiposity in primary total joint arthroplasty patients [21].
  • The soft tissue-to-bone ratio reflects local anatomical factors that directly influence surgical exposure and wound healing, unlike BMI [19].

Modifiability and Intervention

  • Obesity is modifiable, and addressing the issue can improve the orthopaedic and overall health of children [1].
  • Physical activity equivalent to approximately 30–35 min of vigorous intensity per week appears to offset the association between abdominal obesity and incident cardiovascular disease [8].
  • When combined with liraglutide treatment, exercise results in a more holistic state of health that may result in improved longer-term health and may enhance adherence to the treatment and promote longer-term weight-loss maintenance [12].
  • An aggregate exercise programme energy expenditure (>10 000 kcal) may be required to promote reductions in intrahepatic fat [13].

What the Evidence Shows

Systemic and Metabolic Associations

  • Obesity is a systemic disease with profound inflammatory consequences on joint health, extending beyond mechanical burden [5].
  • An aggregate exercise programme energy expenditure greater than 10,000 kcal may be required to promote reductions in intrahepatic fat in adults who are overweight or exhibit fatty liver disease [13].
  • Physical activity equivalent to approximately 30–35 minutes of vigorous intensity per week appears to offset the association between abdominal obesity and incident cardiovascular disease [8].

Pediatric and General Health

Preoperative Weight Management

  • Semaglutide appears to be a safe alternative to bariatric surgery for weight management before total hip arthroplasty, with similar implant survival and postoperative complication rates [17].
  • In patients with severe obesity and advanced knee osteoarthritis, total weight loss percentage was higher in bariatric surgery patients (28.7%) compared to those undergoing immediate total knee arthroplasty [26].
  • Women had decreased odds of losing greater than five pounds before surgery despite increased odds of having preoperative bariatric surgery [18].
  • Women with high-intensity interval training had significant reduction in their weight and BMI compared to those who followed a moderate-intensity continuous training protocol [27].

Knee Arthroplasty

  • Current evidence does not support the routine use of tibial stem extensions in obese total knee arthroplasty patients due to insufficient, heterogeneous, and very low certainty data, though specific designs may benefit selected populations [7].
  • Obesity remains a critical risk factor for mechanical failures in functionally aligned image-based robotic total knee arthroplasty, despite comparable functional outcomes [14].
  • Obese patients are at increased risk of a higher rate of revision following unicompartmental knee arthroplasty [31].
  • The numbers of patients with a BMI ≥ 45 were too small to draw conclusions regarding the safety of cementless total knee arthroplasty in that specific group [4].

Hip Arthroplasty

  • In morbidly obese patients, dual mobility implants demonstrated excellent five-year survivorship with outcomes comparable or slightly superior to fixed-bearing constructs [24].

Hip Arthroscopy and Rotator Cuff

  • Obese and overweight patients converted to total hip arthroplasty at significantly higher rates compared with normal-weight patients following hip arthroscopy for femoroacetabular impingement syndrome [16].
  • Hip arthroscopy for the treatment of femoroacetabular impingement and labral tears in patients with obesity yielded significant and sustainable long-term improvements, which were equivalent to those of a benchmark matched control group of normal-weight patients [25].
  • No significant differences were observed between above-average and below-average BMI groups, and BMI was not correlated with clinical improvements following arthroscopically assisted posterior latissimus dorsi tendon transfer for irreparable posterosuperior rotator cuff tears [9].

Practical Considerations

Pediatric and Systemic Health

  • There is significant confusion regarding the relationship between energy intake, energy expenditure, and obesity, with greater attention historically focused on diet than on physical inactivity [3].

Bone Density and Cardiovascular Risk

  • Each 1-unit increase in body mass index is associated with a 9% reduction in osteoporosis risk [2].

Total Knee Arthroplasty

  • A body mass index of 45 is identified as a safe cut-off for cementless total knee arthroplasty, though sample sizes were too small to draw conclusions for patients with a BMI ≥ 45 [4].
  • Body mass index greater than 40 is not correlated with early complications in patients undergoing primary total joint arthroplasty at an ambulatory surgical center [6].
  • Focusing on the management of preoperative comorbidities and custom surgical planning can achieve outcomes comparable to those of patients with normal BMIs at ambulatory surgical centers [6].
  • Specific tibial stem extension designs may benefit selected populations of obese total knee arthroplasty patients [7].
  • Increasing obesity severity is not associated with higher rates of postoperative stiffness or inferior outcomes following manipulation under anesthesia [10].
  • Concern for stiffness alone should not serve as a categorical barrier to total knee arthroplasty or manipulation under anesthesia when clinically indicated [10].

Total Hip Arthroplasty

  • The World Health Organization obesity class is not associated with the risk, invasiveness, or timing of reoperations after total hip arthroplasty in obese patients [15].

Shoulder and Rotator Cuff

  • Body mass index does not affect clinical outcomes following arthroscopically assisted posterior latissimus dorsi tendon transfer for irreparable posterosuperior rotator cuff tears [9].
  • No significant differences were observed between above-average and below-average BMI groups regarding clinical improvements in arthroscopically assisted posterior latissimus dorsi tendon transfer [9].
  • Obesity is associated with an increased risk of all-cause revisions in patients receiving reverse total shoulder arthroplasty indicated for fractures [23].
  • Obesity is associated with an increased risk of revision for instability or dislocation in patients receiving reverse total shoulder arthroplasty indicated for fractures [23].

Key Evidence

  • [L5] Obesity is modifiable, and addressing the issue can improve the orthopaedic and overall health of children. [1] (10.5435/jaaosglobal-d-19-00036)
  • [L1] Based on our dose–response analysis of nine studies, each 1-unit increase in BMI was associated with a 9% reduction in osteoporosis risk. [2] (10.1186/s12891-026-09675-3)
  • [L5] There is enormous confusion about the relation of energy intake and energy expenditure to obesity, with much more attention focused on diet and obesity than on physical inactivity and obesity. [3] (10.1136/bjsports-2015-094911)
  • [L3] However, the numbers were too small to draw conclusions in patients who have a BMI ≥ 45. [4] (10.1016/j.arth.2025.12.038)
  • [L5] Obesity is more than a mechanical burden on the knee; it is a systemic disease with profound inflammatory consequences on joint health. [5] (10.1002/arj.70051)
  • [L3] Focusing on management of preoperative comorbidities and custom surgical planning can achieve outcomes comparable to those of patients who have normal BMIs at ASCs, questioning BMI as an exclusion criterion and advocating for more inclusive, evidence-based patient selection. [6] (10.1016/j.arth.2025.08.065)
  • [L5] The authors conclude that current evidence does not support the routine use of tibial stem extensions in obese total knee arthroplasty patients due to insufficient, heterogeneous, and very low certainty data, though specific designs may benefit selected populations. [7] (10.1016/j.arth.2025.11.056)
  • [L3] Physical activity equivalent to approximately 30–35 min of vigorous intensity per week appears to offset the association between abdominal obesity and incident CVD. [8] (10.1136/bjsports-2023-107252)
  • [L2] No significant differences were observed between above-average and below-average BMI groups, and BMI was not correlated with clinical improvements. [9] (10.1016/j.xrrt.2025.100634)
  • [L3] These findings suggest that increasing obesity severity is not associated with higher rates of postoperative stiffness or inferior outcomes following MUA and that concern for stiffness alone should not serve as a categorical barrier to TKA or MUA when clinically indicated. [10] (10.1016/j.arth.2026.03.080)
  • [L3] These findings suggest modern surgical practices and implant designs may have mitigated traditional obesity-related risks. [11] (10.1016/j.arth.2026.04.031)
  • [Paper] It is clear that, when combined with liraglutide treatment, exercise results in a more holistic state of health that may result in improved longer-term health and may enhance adherence to the treatment and promote longer-term weight-loss maintenance. [12] (10.1136/bjsports-2021-104754)
  • [L1] An aggregate exercise programme energy expenditure (>10 000 kcal) may be required to promote reductions in intrahepatic fat. [13] (10.1136/bjsports-2016-096197)
  • [L3] However, obesity remains a critical risk factor for mechanical failures. [14] (10.1016/j.jisako.2025.100861)
  • [L3] In this cohort of obese patients who underwent THA, the WHO obesity class was not associated with risk, invasiveness, or timing of reoperations. [15] (10.1016/j.arth.2025.07.026)
  • [L3] Obese and overweight patients converted to THA at significantly higher rates compared with normal-weight patients. [16] (10.1177/03635465251400355)
  • [L3] Semaglutide appears to be a safe alternative to bariatric surgery for weight management before THA, with similar implant survival and postoperative complication rates. [17] (10.1016/j.arth.2025.08.068)
  • [L3] Women had decreased odds of losing greater than five pounds before surgery despite increased odds of having preoperative bariatric surgery. [18] (10.1016/j.arth.2026.06.021)
  • [L3] Unlike BMI, the STiB ratio reflects local anatomical factors that directly influence surgical exposure and wound healing. [19] (10.1016/j.arth.2025.09.022)
  • [L1] Following MMPRT repair, repairs show progression of osteoarthritis with higher rates seen with elevated BMI. [20] (10.1002/arj.70028)
  • [L3] BMI has a weak-to-moderate association with peri-incisional adiposity in primary total joint arthroplasty patients. [21] (10.1016/j.arth.2024.08.020)
  • [L2] However, a nonsignificant trend toward a higher complication rate was observed in patients with severe obesity (BMI ≥35 kg/m2), while a statistically significant increase in arthrofibrosis was found in patients with BMI <25 kg/m2. [22] (10.1016/j.jisako.2025.100927)
  • [L3] Obesity has an increased risk of all-cause revisions and revision for instability or dislocation in patients receiving rTSA indicated for fractures. [23] (10.1016/j.jse.2025.05.036)
  • [L3] In morbidly obese patients, DM implants demonstrated excellent five-year survivorship with outcomes comparable or slightly superior to fixed-bearing constructs. [24] (10.1016/j.arth.2026.03.075)
  • [L3] Hip arthroscopy for the treatment of FAI and labral tears in patients with obesity yielded significant and sustainable long-term improvements, which were equivalent to those of a benchmark matched control group of normal-weight patients. [25] (10.1177/03635465251392585)
  • [L1] Total weight loss % was higher in bariatric surgery patients (28.7%, P < 0.001). [26] (10.1016/j.arth.2026.05.033)
  • [L1] Additionally, women with HIIT training had significant reduction in their weight and BMI compared to those who followed MICT training protocol. [27] (10.1186/s12891-026-09722-z)
  • [L3] The ten-year functional outcomes and revision rates of THA do not justify restricting access to surgery on the basis of BMI. [28] (10.1016/j.arth.2025.07.044)
  • [L3] Based on AOANJRR data, obese patients are at increased risk of higher rate of revision following UKA. [31] (10.1177/2325967125s00336)

References

[1] The Role of Obesity in Pediatric Orthopedics. JAAOS: Global Research and Reviews. 2019. DOI: 10.5435/jaaosglobal-d-19-00036

[2] The association between body mass index and osteoporosis, with consideration of sex differences: a systematic review and dose-response meta-analysis. BMC Musculoskeletal Disorders. 2026. DOI: 10.1186/s12891-026-09675-3

[3] It is time to bust the myth of physical inactivity and obesity: you cannot outrun a bad diet. British Journal of Sports Medicine. 2015. DOI: 10.1136/bjsports-2015-094911

[4] Body Mass Index of 45 Is a Safe Cut-Off for Cementless Total Knee Arthroplasty. The Journal of Arthroplasty. 2025. DOI: 10.1016/j.arth.2025.12.038

[5] Reframing Obesity in Knee Osteoarthritis: A Call for a Transdisciplinary Approach Beyond Biomechanics. Arthroscopy. 2026. DOI: 10.1002/arj.70051

[6] Body Mass Index > 40 Is Not Correlated With Early Complications in Patients Undergoing Primary Total Joint Arthroplasty at an Ambulatory Surgical Center. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2025.08.065

[7] Reply to: "Letter to the Editor Commenting on: 'Current Evidence Does Not Support the Use of Tibial Stem Extension in Total Knee Arthroplasty of Obese Patients: A Systematic Review'". The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2025.11.056

[8] Joint associations of device-measured physical activity and abdominal obesity with incident cardiovascular disease: a prospective cohort study. British Journal of Sports Medicine. 2023. DOI: 10.1136/bjsports-2023-107252

[9] Body mass index does not affect clinical outcomes following arthroscopically assisted posterior latissimus dorsi tendon transfer for irreparable posterosuperior rotator cuff tears: a minimum 5-year follow-up study. JSES Reviews, Reports, and Techniques. 2026. DOI: 10.1016/j.xrrt.2025.100634

[10] Obesity Severity and Stiffness After Total Knee Arthroplasty Revisited: A Contemporary Analysis of Patients Requiring Manipulation Under Anesthesia. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2026.03.080

[11] Obesity and Total Knee Arthroplasty Revisited: Minimal Impact on Loosening and Mechanical Failure in the Modern Era. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2026.04.031

[12] Exercise in the maintenance of weight loss: health benefits beyond lost weight on the scale. British Journal of Sports Medicine. 2021. DOI: 10.1136/bjsports-2021-104754

[13] Effect of exercise training on liver function in adults who are overweight or exhibit fatty liver disease: a systematic review and meta-analysis. British Journal of Sports Medicine. 2016. DOI: 10.1136/bjsports-2016-096197

[14] Impact of high body mass index on functionally aligned image-based robotic total knee arthroplasty: Comparable functional outcomes but higher mechanical failures. Journal of ISAKOS. 2025. DOI: 10.1016/j.jisako.2025.100861

[15] Obesity Class Does Not Associate With Incidence, Timing, or Invasiveness of Reoperations After Total Hip Arthroplasty. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2025.07.026

[16] The Effect of Body Mass Index on Outcomes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome: A Matched Analysis With 10-Year Follow-up. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465251400355

[17] Is Semaglutide a Safer Weight-Management Option Than Bariatric Surgery for Patients Undergoing Total Hip Arthroplasty (THA)?. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2025.08.068

[18] Disparities in Preoperative Weight Loss and Obesity Treatment Before Total Joint Arthroplasty. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2026.06.021

[19] Soft Tissue-To-Bone Ratio Outperforms Body Mass Index in Predicting Periprosthetic Joint Infection in Total Knee Arthroplasty: A Retrospective Case-Control Study. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2025.09.022

[20] Medial Meniscus Posterior Root Tear Repairs Show Osteoarthritis Progression Over Time With Higher Rates Seen With Higher Body Mass Index. Arthroscopy. 2026. DOI: 10.1002/arj.70028

[21] Body Mass Index is Not an Appropriate Proxy for the Condition of Peri-Incisional Adiposity in Primary Total Joint Arthroplasty Patients. The Journal of Arthroplasty. 2025. DOI: 10.1016/j.arth.2024.08.020

[22] Impact of body mass index on robotic-assisted total knee arthroplasty outcomes: A retrospective cohort analysis. Journal of ISAKOS. 2025. DOI: 10.1016/j.jisako.2025.100927

[23] Revision rates between obese and nonobese total shoulder arthroplasty patients: an Australian registry data study. Journal of Shoulder and Elbow Surgery. 2026. DOI: 10.1016/j.jse.2025.05.036

[24] Primary Total Hip Arthroplasty in Patients Who Have Morbid Obesity: A Propensity-Weighted Analysis of Dual Mobility and Standard Fixed-Bearing Implants. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2026.03.075

[25] Obese Patients Treated by Hip Arthroscopy for Femoroacetabular Impingement Syndrome — 10-Year Functional Outcomes and Conversion Rates to Arthroplasty Compared With Normal-Weight Patients. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465251392585

[26] Impact Of Prior Bariatric Surgery Versus Immediate Total Knee Arthroplasty On Knee Function Among Patients Who Have Severe Obesity And Advanced Knee Osteoarthritis: The SWIFT Trial. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2026.05.033

[27] Impact of high-intensity interval training vs. moderate-intensity continuous training combined with strength training on physical and metabolic outcomes in post-bariatric surgery patients with sarcopenic obesity. BMC Musculoskeletal Disorders. 2026. DOI: 10.1186/s12891-026-09722-z

[28] Do the Ten-Year Functional Outcomes and Revision Rates of Total Hip Arthroplasty in Obese and Morbidly Obese Patients Justify Restricting Their Access to Surgery?. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2025.07.044

[31] Obesity is Associated with Higher Rates of Revision Following Unicompartmental Knee Arthroplasty. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/2325967125s00336

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