A rare total knee replacement in Apollo

A morbidly obese lady gets new knees to lose weight

New Delhi, September 22: Her knees got mangled under her weight. Her first priority should have been to go for bariatric surgery get freedom from her unbearable burden. But she opted for new knees to lose weight.

A 120 kg Kenyan lady with 52.6 BMI got her both knees replaced in Indraprastha Apollo hospital. Such morbidly obese person is not indicated for knee replacement before weight loss bariatric surgery but Dr. Raju Viashya, Senior Consultant Orthopaedic & Joint Replacement Surgeon, Indraprastha Apollo Hospitals made it. The twist in the tale is that she now plans to lose weight, walking on her new found legs.

According to Dr. Vaishya, it is certainly his first in his about 30 years of knee replacement practice. Talking to meditoall editor in chief Dhananjay kumar, Dr. Vaishya said, ‘Doing Total Knee Arthroplasty (TKA) on both knees in such a morbidly obese person is a very tough proposition and is rarely done. But I had no choice, given her insistence on knee replacement. Dr. Viashya further said, ‘It is my first and probably unheard in whole of India so far. I feel personally gratified to do such a rare surgery.’

Obesity had led to crippling arthritis of knee in her. She was suffering from arthritis of both knees for years. Due to knee pain and morbid obesity, she was unable to walk and do her daily living chores and was almost wheelchair bound. To curb the pain, she would take steroids on regular basis. Her height was 151cms (BMI:  52.6) and was thus in the category of super morbid obesity. She also had other co morbidities, namely, high blood pressure and undiagnosed diabetes.

Dr. Vaishya said, ‘We had to first optimize her medical conditions before going for Total Knee Arthroplasty (TKA) on her both knees in staged manner. And now, she can walk without any pain. She has even decided she would walk more with these new found knees to lose weight. And who knows, she might become lean without bariatric surgery. There is strong evidence linking excessive body weight to degenerative joint disease of the knee. Obesity is an important risk factor for the development of osteoarthritis (OA), especially of the knees.’

It has also emerged that in obese people fat tissues produce a hormone called Leptin, which may affect the cartilage metabolism and cause arthritis. Weight reduction is very useful for the patients suffering with obesity since it has shown significant benefit in improvement of symptoms and progression of arthritis.