TKR Morbidly Obese Help

[knee-adjacent]

Hello!

My husband needs TKR on both knees. His BMI is 60. He’s bone on bone. He does have an obesity medicine doctor and he is losing weight but it would take 3 years to get down to 40. The last suggestion we had was bariatric surgery and that makes me angry… if he’s too big for TKR due to his BMI because of anesthesia risks, how the heck is bariatric surgery a solution…

But I digress… He has high blood pressure but that typically only ticks up if he tries to be mobile (pain!). He is not diabetic, not even pre-diabetic. He is not a smoker and has never been. In fact, his doctors say if they only had his bloodwork they wouldn’t even suspect obesity.

Does anyone have a recommendation for a surgeon that will work with him? We’re even considering out of country, that is how much pain he is in…

Thank you!

 

[mendogal]

Welcome!
Here's a BoneSmart article that discusses getting second opinions in this situation.

If you would share your approximate location, a moderator may have some thoughts on surgeons, as may some of our members.

 

[knee-adjacent]

Thank you! We are in Marietta GA. Any recommendations for orthopedic surgeons that help patients with high BMIs is appreciated!

 

[Layla]

I am really sorry for all you're dealing with as a couple. I hope with the care of good medical professionals you're able to turn some of this around for a better quality of life. All the best to you!

Here is a list Admin provided in the recent past. You mentioned you're willing to travel, so hopefully it's a good start for you to begin researching.


Melnic, Christopher M., MD
Kwon, Young-Min, MBBS, PhD
Bedair, Hany S., MD


Per Jamie from Admin -
Unfortunately the 40 BMI is the standard cutoff for most surgeons, due to the higher risk of infection associated with high BMI patients. But there are doctors out there....you may just need to travel to consult with them. Here is the list of surgeons to try.

Orthopedic Surgeons for Hig BMI Patients
Washington DC

Bethesda
Dr. Sridhar M. Durbhakula
Hip and knee primary and complex revision (recommended by Mark)
Works with high BMI patients also


Chattanooga, Tennessee
Dr. Kristopher Case Sanders, MD
Anterior/posterior hips, works with high BMI patients
Erlanger Orthopaedics
979 E 3rd St,, Suite C-430
Chattanooga, TN 37403
423-778-4900


Cleveland, Ohio
Cleveland Clinic
Primary and revision hips and knees
Dr. Bernie Stulberg(Cleveland Clinic) - works with high BMI patients
Dr. Ken Greene(Medina/Cleveland Clinic) - works with high BMI patients


Durham, North Carolina
Dr. Ralph Liebelt (now retired)
120 William Penn Plaza
Independence Park
Durham, NC 27704
Phone: 877-959-2856
Works with high BMI patients. Recommended by Mark (via Daniel Hill; Area Director, NC, Joint Replacement; (919) 632-6352 Call to see if other doctors in practice will accept high BMI patients.


Richmond, Indiana (on the border with Ohio)
Works with high BMI patients.
Mario Lee, M.D.
Reid Health
1400 Highland Rd, Richmond, IN 47374
(765) 935-8905
Reid Hospital Orthopedics
@knee-adjacent

 

[mendogal]

There may be specific factors in joint replacement besides the anesthesia risk that make a GI surgeon more willing to do bariatric surgery than a ortho surgeon to do a knee replacement:

The high BMI does increase the risk of post-op infection, which on new joint implants can be a path to long term IV antibiotics plus multiple follow up revision surgeries.

There may also be concern about the effect of high BMI on both the weight-bearing capacity of the implants and the ability of the patient to actively mobilize in recovery.

These are factors to openly discuss with any of the ortho surgeons the two of you consult with. I hope you're able to follow up and please keep us in the loop as you pursue answers and a path forward.

 

[Jamie]

Thanks, @Layla , for posting this list. These are all the surgeons I have at this time that may be able to help in this case. Please let us know how things go and if you plan to see one or more of these surgeons.

 

[Jockette]

Fortunately my surgeon was very compassionate and took me in spite of a BMI over 50. 2 weeks post op and I'm healing beautifully.

This is luvcats’ surgeon:

Kevin B. Fricka, MD | Orthopaedic Surgeon in Arlington, VA

Dr. Kevin Fricka is a knee and hip surgeon who is dedicated to providing the best in orthopaedic care for patients in Northern Virginia.

andersonclinic.com

@luvcats Thanks for sharing the name of your surgeon with me a few years ago!