Joint replacement surgeries - including hip, knee and shoulder replacements - can significantly improve quality of life. Many patients with obesity are denied these procedures despite a lack of formal recommendations from national organisations. Evidence on the risks of joint replacement surgery in patients with obesity is limited and mixed.
In this study, researchers analysed more than 20,000 elective shoulder replacement surgeries performed across the UK and Denmark to see whether BMI was associated with death or other complications.
Compared to patients with a healthy BMI (21.75 kg/m2), patients with obesity (BMI 40 kg/m2) had a 60% lower risk of death within the year following surgery. Those considered underweight however, (BMI <18.5 kg/m2) had an 18% higher risk of death, in addition to an increased risk of other poor outcomes. The study does not support restricting patients with a high BMI from having elective shoulder replacement surgery, contrary to evidence that some hospitals are starting to restrict patients.