Hip replacement and BMI.

[JohnTheRevelator]

Has anyone on here had a hip replacement when their BMI has been in the overweight/obese category? I am on the waiting list to have a hip replacement and at the moment my BMI is 32. A couple of years ago it was 44,but I've managed to lose 7 stone. I'm trying to lose another 3 stone at the moment. A few people have told me that it wouldn't be a barrier to having a hip replacement,but several things that I have read indicate otherwise. I'd hate to miss out on the op because my BMI is too high.

Didn't mean to activate the AYBU/YANBU!

I don’t know but well done for losing 7st!!

I would have thought your GP/Consultant are the ones to ask, but well done on the weight loss!

Thank you! I am rather pleased about it!

Thank you! I have asked my GP (or one of the GPs at my practice) but he was rather non-committal about it. He was also rather dismissive of my weight loss so far,preferring to concentrate on the fact that I was still 3 stone overweight,than the fact that I'd lost 7 stone! 🤬

The heavier you are the greater the risk from surgery

At your peak you may well have been told that they wouldn't operate until you lost weight

Well done on that weight loss - probably puts you in a much better position

Well done on your weight loss! DH had a bmi of 30 and had his hip replaced 2 years ago. He was then able to exercise pain free and lose weight to get into a healthier range so I would say you stand a good chance of getting it done. Good luck!

I am waiting for both my hips to be replaced - I have a BMI of 27 (very firmly in the overweight range). I saw the consultant last week and nothing was said about it.

Well done on thr weight loss (especially with needing a hip replacement).

Have you asked your surgeon? If you're already on the waiting list and they've not mentioned it then you must be under their max. Or did they add you with a view to reviewing progress again pre-op (in which case they should have given you a target/rough idea of the timescale). Well done for the weight loss - it really does make a difference to the operation, anaesthetic and perioperative risk (doi: anaesthetist).

BILs ortho consultant told him he had to lose weight before he'd be considered for hip replacement (he was probably 25 stone). Because he has a number of other significant health issues he was prescribed WLI to lose the weight, which he did, and had the op on his right hip. Recovery was uneventful but sadly the weight has crept back on and now his left hip is giving him problems so he may have to go though the whole weight loss process again to get the other hip done.

Well done on the loss. The fitter (and therefore nearer ideal weight you are) the more likely you’ll recover well from surgery. Not sure whether you’ll be able to have the over not but I’d suggest you continue what you’re doing as well as engage with gp.

The Nice guidance for hip and knee replacement specifies that BMI is not an exclusion criteria for surgery, however the decision to operate will always be a risk vs benefits discussion and it's likely the anaesthetist will have final say. In the trust where I work you would be able to have your surgery on our main base sites but not in our peripheral hub sites. You've done really well to lose so much weight and this will massively reduce your risk of complications post op.

I'm similar in having lost 6 stone my bmi is 39. I need hips and knees doing, they have been a problem since I was 16 and a normal weight. My weightloss was acknowledged but was told if you could lose another 6 stone!. I have been referred to a different surgeon for different ops as I am apparently too young for joint replacements at 45. My neighbour has just had a knee replacement with a bmi of 40 so would hope 32 would be OK but it's up to your surgeon in the end

That sounds encouraging. I've only just gone on the waiting list so I know I'm looking at probably a 6 month wait at least. Hopefully by then I'll have lost a bit more!

You'll be fine. My hospital do high bmi hip/knee replacements all the time. You can also show that you have lost a significant amount of weight already. You'll be fine.

Thank you to everyone who has complimented me on my weight loss,it means a lot to me!

It's very unlikely the anaesthetist will have the final say! 😆 (they also won't be worried about a patient with a BMI of 32)

@JohnTheRevelator as ever with the postcode lottery it depends on the area you live in…but yes, many areas do restrict by BMI, as you are now under 35 I doubt they would refuse you on the basis of obesity now… ( but age and eg. Smoking status are often also taken into account too). You have done amazingly well and if you can just carry on a bit longer and get under 30 you will be improving many of your health outcomes.you could also google your local health areas joint replacement policies, you may be in luck and find a document. https://www.pulsetoday.co.uk/news/clinical-areas/musculoskeletal-and-rheumatology/bmi-limits-on-hip-surgery-should-be-axed-to-reduce-inequality/

I hope you get it sorted. It’s wrong that BMI on its own causes much of a higher risk. If you have other conditions, that’s understandable of course. I believe there’s a slightly higher risk for DVT but they can account for that.

Just had my second one done and bmi was around 30-31 for each surgery. As long as you don’t have any other issues you should be fine and recovery will enable more exercise within weeks - do as much exercise before surgery as you can (cycling in or outdoors and swimming are great for hips and knees) and just make sure you stick with your eating plan post surgery as weight may creep on during the 6 weeks recovery
well done on your weight loss so far

Well done that's fab! Tbh bmi of 32 is pretty small for most of the people I anaesthetise for for hip replacements so doubt it is reason you couldn't proceed

The surgeon will decide whether the OP can be added to the waiting list. At our place the pre op anaesthetist will flag all patients who are at increased risk (we have an early screening system in situ) and will review the records and decide if they want to see the patients in anesthetic pre op clinic. They will consider lower risk approaches where feasible but will have the veto on whether a major surgery goes ahead. As I said in my previous post, the OP's BMI would not restrict her having surgery on some of our sites and a patients overall health status would be considered in the round, not as a single metric

I had a hip replacement when I was a size 16. Can’t remember what my BMI was at the time but think it would have been about 32 same as now.

Losing 7 stone is such an achievement, well done!

@Whatsherusername I had mine done at 33 and 40... No such thing as too young surely if it's a health issue which needs sorting?

OP, I was slightly overweight and losing the weight before the surgery and also being as for as I could (within the constraints of my hip issues) made a huge difference. The first one where I was fitter was a breeze, second one carrying more weight and being less fit overall was a harder recovery but doable 💪🏼 Good luck!

@mynamechangemyrules they don’t want to replace too early if possible as at the end of the day all joint replacements have a life span…somebody needing to undergo multiple revisions because they had to have one in their early 40’s is going to be at increased risk the older they get.