An optimal body mass index for adults is no higher than 24.9, according to the CDC. Patients with a BMI of over 30 are considered high-risk for the majority of orthopedic and spine procedures, while patients with a BMI of over 40 are often turned away by surgeons.
While some surgeons may be hesitant to operate on high BMI patients, some facilities have taken steps to reduce the risks so they can perform various musculoskeletal operations, from total knee arthroplasty to lumbar spine fusions, on these patients.
Here is what three practices are doing to best treat high BMI patients:
1. Burnsville, Minn.-based Inspired Spine established two Centers of Excellence in rural areas of Kansas and Minnesota that specialize in providing complex spine care for patients with a high body mass index. Inspired Spine's oblique lateral lumbar interbody fusion technology and comprehensive surgical protocols have minimized associated risks for patients requiring spinal fusion surgery. The OLLIF procedure has been used to treat high BMI patients for the last decade.
2. Orthopedic surgeon Kevin Borchard, MD, and sports medicine and nutrition physician Justin Grant, DO, are working together at the Colorado Advanced Orthopedics, Sports Medicine and Spine center in Meeker to treat patients with an elevated BMI who need orthopedic procedures.
3. Rochester, Minn.-based Mayo Clinic is taking steps to help patients with a BMI of over 40 safely undergo total knee and total hip arthroplasty. Orthopedic surgeons connect patients with physicians specializing in weight loss before the procedure. Mayo physicians also emphasize using compassion and a "can-do" attitude, as many of their high BMI patients have been denied surgery elsewhere. Physicians work with patients to set reasonable health improvement goals. Rather than turning away high BMI patients, Mayo offers a multidisciplinary approach that includes activity modification, injections, medications, and working with bariatric surgery and weight-loss teams to set goals.