Obesity causes more serious orthopaedic problems


June 6, 2014

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Obesity has often been linked to causing osteoarthritis through increased wear and tear on weight-bearing joints.

Obesity has often been linked to causing osteoarthritis through increased wear and tear on weight-bearing joints. However, a recent study by the American Academy of Orthopaedic Surgeons suggests obesity may cause osteoarthritis in more ways than just wear and tear. In a report published by Jonathan Bravman, M.D., and Ryan Koonce, M.D., the doctors noted that obesity can cause osteoarthritis in joints that do not bear weight as well.

"Studies show that even in non-weight-bearing joints such as the hand, the presence of osteoarthritis is increased in obese patients compared to non-obese patients," Koonce said. "In those non-weight-bearing joints, loading isn't likely to be a factor in the development of OA."

According to the doctors, obesity may cause OA hormonally because body fat tissue releases pro-inflammatory chemicals that may damage articular cartilage. 

Additionally, orthopaedic surgeon Michael Necci, M.D., said that obesity tends to cause a decrease in physical activity and movement, which impacts joints negatively by reducing muscle surrounding joints and decreasing blood flow.

"The cartilage inside our joints does not have a blood supply in and of itself," Necci said. "It gets nourishment from moving the joints and circulating the fluid throughout the joint."

A national issue
The U.S. Centers for Disease Control and Prevention notes that over one-third of the American adult population is obese and that obesity-related health issues cost the U.S. roughly $147 billion in medical expenses in 2008. What's more, obesity is linked to some of the most prevalent preventable death conditions such as heart disease and stroke. Worse yet, the rate of obesity has taken a sharp incline in recent decades, doubling in the years from 1960 to 2000, and obesity rates have surpassed 20 percent in every U.S. state.

Total joint replacements caused by obesity have increased sevenfold since the 1970s - from 3 percent to 20 percent - according to Necci. Necci says obesity is linked to additional total joint replacement as a secondary cause as well.

An issue in children
The National Center for Biotechnology Information states that obesity among children has tripled from 1980 to 2000. The current rate of obesity among American children ages 2-19 years is 17 percent, according to the CDC. Additionally, the group reports that from 2011-2012 over 20 percent of children ages 12-19 could be classified as obese. Along with several other severe health issues, obese children are at greater risk for several orthopaedic problems such as spinal complications, Blount disease, acute fractures and slipped capital femoral epiphysis.

Focusing on weight loss
Orthopaedic physicians are encouraged to educate patients about weight loss options. Bravman and Koonce suggest using weight loss resources as primary care options for certain patients musculoskeletal pain and OA. Necci suggests exercises that are less shock intensive on the joints for OA patients such as swimming or biking. The CDC suggests that weight can be lost through a combination of healthy eating, exercising frequently and adjusting caloric intake according to physical activity from day to day. 


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