Obesity is a fast-growing problem, more actual than ever.

We talk about obesity when the excess of a body mass index (BMI) of 30 occurs. In the United States, it is estimated that obesity has increased by the 34,9% between the overall population, although it is becoming a constantly growing problem in Italy.

Obesity is the result of a complex interaction between behaviours, environmental factors and genetic predisposition and it is linked to an intensified risk of many chronic diseases, from diabetes to hypertension.

Obesity role in orthopedics.

In the same way, the relationship between obesity and orthopedics is strong and important as well. Some body parts like hips and knees are highly affected by this pathology which weighs on ankles as well, although to a lesser extent. In fact, obesity partially affects ankle arthrosis in comparison with hips and knees, but it plays a key role in the surgical outcome. Generally, as for foot and ankle pathologies, obesity has indeed a negative effect on the post-operative. Literature reports a considerable increase in complications, especially as regards the infectious risk, the delay in surgical wound healing, and the risk of thromboembolic events.

Obesity complications for ankle prosthesis.

obesity and ankle

Talking about ankle prosthetics, obesity exposes to an increase of the above-mentioned complications and has a negative effect on post-operative recovery too, by slowing it. In fact, patients, evaluated with specific clinical assessment scales, report a surely present and constant recovery from normal daily activities and a relief from pain. Howewer, if they are compared with normal BMI (body mass index) patients, their recovery is undoubtedly less rapid and reaches less satisfying values.

On the other hand, literature disagrees more with the inspection rate of the obese patient. Some articles highlight how this risk has increased, while some others stress that the correct prosthetic implant positioning can fix this eventuality.

Another fact, which is important to highlight and which various authors seem all to agree on, is body weight reduction. In one of his articles, Beat Hintermann, points out indeed a significative weight loss (by 5% or more) in 12% of patients who undergone an ankle prosthesis operation, a year after, to be connected to the recovery from normal daily activities and from physical activity.

Commented articles:
Gross CE1, Lampley A2, Green CL3, DeOrio JK2, Easley M2, Adams S2, Nunley JA 2nd2. The Effect of Obesity on Functional Outcomes and Complications in Total Ankle Arthroplasty. Foot Ankle Int. 2016 Feb;37(2):137-41.
Barg A1, Knupp M, Anderson AE, Hintermann B. Total ankle replacement in obese patients: component stability, weight change, and functional outcome in 118 consecutive patients. Foot Ankle Int. 2011 Oct;32(10):925-32.