After ten years with this disease, both knees are shot. Orthopedic doctor told me this week that both are so arthritic, he would flip a coin as to which to do a replacement first. THEN he told me that being immunosuppressed and also having an “obese BMI” will make my possible side effects, especially clots or infection, worse. He can’t do the surgery until April or May and wants me to lose as much weight as I can. Being on Medicare, the new obesity medications aren’t covered. I am curious as to why obesity lends towards having more infection postop. I understand about my medications making it easier to become infected and not being able to fight infection. So. My question is, has anyone out there with psoriatic arthritis and also high BMI had a knee replacement successfully?
I did. Actually I had both done. I am considered obese, although I had been doing yoga for some time. The first replacement was before I was diagnosed with PsA. My knee had deteriorated extremely quickly over two months and the surgery happened very quickly. My recovery was just brutal. Months later, still in pain, I was referred to a rheumatologist who began treatment for PsA.
The second replacement, done about a year later, was totally different. I was doing yoga after 6 weeks!
So, in my experience, knee replacement is absolutely possible. Following medical advice, doing the physiotherapy religiously and trying to exercise as much as possible worked very well for me. The doctors are correct to tell you about the risk of infection and clots - those darned white cells! - but they also know how to manage the dangers. I wish you good luck. P. S. Thé afterwards (I’m 10 years out) is well worth it!
Another chicken and egg problem. Exercise, it will help the arthritis, they say. But it HURTS to exercised!
My knees are becoming an issue also. I am a little overweight at 6’5"and 320 lbs. I had dropped 25 pounds on Ozempic, but insurance stopped paying for it and I put most of it back on.
Sometimes I am not sure how I am supposed to lose weight, other than stop eating.
Obesity is associated with an altered immune response which can lead to an increased risk of infection. Excessive weight also stresses the respiratory system, increases soft tissue burden, and impairs skin and urinary tract hygiene. Chicken or egg? Perhaps but despite all the voodoo weight loss science out there, the one thing that is incontrovertible is if you consume more calories than you burn, you create fat. These magic weight loss drugs have done more to prove that concept than any number of studies. It’s simple people consume fewer calories when on them than they normally do. FWIW I have had four joint replacements two when obese (300+) and 2 at under 200. The difference is night and day in recovery, pain levels, and pain management. In fact with my last shoulder replacement, the only pain meds I took were in the recovery room. I woke up to the smiling face of my physical terrorist of the week, no sling. Etc. she was flexing me in the elevator on the way down to my room (I did receive IV Tylenol and some torodol.
For some reason the knee is more prone to infection than any other joint. It’s probably because it is the most stressed. But whatever the reason. It is also the most difficult infection to treat. Largely because of poorer blood circulation.and the proximity of lymph nodes that create a lot of inflammation in the area particularly in women.
I think we all have had a doc or two who has infuriatingly has told us to lose weight as if that was the answer to everything, and you just want to slug him. But you know what, it’s like eating an elephant and some basic physics. Losing the 50 or more pounds to get the perfect BMI but 1pound only takes (3500) calories or one soda a day for a week to lose and will take 5 pounds of stress/weight off each knee.
You don’t need to lose a lot of weight to make a huge difference in surgical outcomes. Good luck.
I am recovering right now, and it’s been trying. I can see how losing weight would make it easier. I have been off my cosyntix for 8 weeks; I’m hoping I get the okay to start back. I’m really starting to feel it all over this last week. I have so many friends and family who say I’ll be so happy I did it.