Most individuals planning hip replacement surgery do not need to worry about weight. If you are very overweight, then losing weight before surgery may be helpful. Under the best of circumstances, it is hard to trim even a few pounds. If your hip is painful, it is even more difficult to move about and to exercise. This makes weight loss all the more difficult. Nevertheless, being overweight does present certain problems for surgery.
An overweight patient with a large amount of soft tissue around the hip requires a longer incision and wider surgical exposure to reach the hip joint. This means increased surgical time and often a greater blood loss. More retraction is required during surgery and this puts deeper structures such as the sciatic nerve at risk.
Overweight patients have a greater tendency towards wound healing problems which may lead to infection. In the postoperative period, extra weight makes physical therapy and mobility more difficult.
Heavier patients are at higher risk for medical complications such as blood clots and thrombophlebitis. Since they have greater difficulty breathing and moving air, there may be an increased incidence of lung problems. Over-weight patients as a group may also have a greater risk of diabetes. In short, overweight patients are more likely to have medical problems in the postoperative period.
The good news is that there is no proven difference in recovery time and no known difference in orthopaedic surgical outcomes between normal and overweight patients. Surprisingly, there is nothing to suggest a higher risk of instability in overweight patients. They may, in fact, be protected because they are unable to flex their hips as much.
We can therefore say that being overweight carries a greater risk of postoperative medical problems, but the overall orthopaedic results are the same. If your weight is a concern, your regular physician and your orthopaedic surgeon can tell you what steps need to be taken before you have surgery.