Obesity leading to joint replacements in young

Patients more likely to need second or third replacement due to limited lifespan of artificial joints

HIP AND knee replacements are required in more and more young people due to obesity, a conference on nutrition has heard.

The comments were made by Dr Bernadette Carr, medical director of VHI, at the conference on obesity organised by the Nutrition and Health Foundation (NHF) in Dublin last week.

Dr Carr said obesity was an independent risk factor in the development of osteoarthritis, particularly of the knee.

She said that those aged 55-64 were particularly at risk as this was the group that presented with early onset arthritis. “Patients presenting for joint replacement are getting younger, are heavier and have a longer life-expectancy than in the past,” she said.

Dr Carr said that because patients with obesity were having joint replacements at a younger age, they were also more likely to need a second or perhaps a third replacement in the course of their lifetime.

“If you have a hip replaced at 50, it’s possible you’ll need it replaced again at 65 and again 15 years later.

“A replaced hip has a limited lifespan and obesity adds to the wear and tear,” she said.

She said VHI had paid €8.2 million for 1,700 hip replacements in the year 2000. However, this rose to €24.1 million for 2,385 replacements in 2009.

She said the insurer had paid €3.5 million for 597 knee replacements in 2000, rising to 1,748 in 2009 at a cost of €22.6 million.

Dr Carr said that while hip, and particularly knee, replacements had become more common and people were living longer, increasing obesity levels – which caused greater pressure on joints – were a significant factor in the rise in joint-replacement operations.

She warned that difficulty with lifting, intravenous access and the higher risk of anaesthetic complications for those who were overweight meant that all surgery for obese patients bore higher dangers.

Dr Carr said VHI had put in place its own screening programme for its members to detect obesity and possible risk factors for stroke, hypertension and type 2 diabetes.

“Obesity brings with it a burden of disease and it’s a burden that society pays for,” said Dr Carr.

“We invite members to come along and be screened.

“From there, we develop a risk profile which gives them the information they need to make changes to their lifestyle.”

Organisers of the conference, NHF, a partnership of industry, State agencies, health professionals and citizens working to address lifestyle, nutrition and health challenges in Ireland, estimates the cost of physical inactivity in Ireland to be €1.6 billion per year.