Increasing patient obesity: Do I or do I not operate?

In Australia, one quarter of our population is obese, and over half is overweight, with the upward trend predicted to continue to increase for the next 20 years or so. This summary paper looks at the influence of obesity on the outcome of total joint arthroplasty, including our own experience in particular with 535 consecutive primary cementless total knee replacements. We found obesity makes the surgery more difficult and patients get poorer range of flexion. They do however get good pain relief, and in the medium term, results are similar to non-obese patients.