TOTAL KNEE REPLACEMENT FOR SEVERE OSTEOARTHRITIS IN AN OBESE PATIENT

Mrs. Thu, 58 years old, had class III obesity and had suffered from chronic joint pain for years. She had undergone multiple conservative treatments, including oral medications, intra-articular hyaluronic acid injections, and physical therapy. While these methods initially provided mild pain relief, her condition recently deteriorated significantly with no signs of remission, severely compromising her daily activities and rendering her unable to perform routine tasks.

Presenting to Sante Hospital, Mrs. Thu experienced severe pain and profound mobility limitations due to her 120 kg body weight. Following a comprehensive clinical examination, the physician indicated total knee arthroplasty (artificial knee replacement surgery) for the patient.

Dr. Tang Ha Nam Anh, MD, PhD, Clinical Advisor of the Department of Orthopedics and Traumatology at Sante Hospital, explained that Mrs. Thu's knee osteoarthritis progressed rapidly due to excess weight and obesity. Excess body mass exerts immense mechanical pressure on the articular cartilage, causing cartilage fissures or fragmentation, thereby accelerating joint degeneration. Furthermore, elevated body fat levels increase the risk of osteophyte (bone spur) formation around the joint, exacerbating pain during movement.

On the first postoperative day, the patient reported a distinct improvement in her knee sensation compared to before surgery. With substantial pain relief and only mild tenderness at the incision site, she was able to ambulate independently with the support of a walker. Optimal pain management facilitated early rehabilitation, rapidly restoring joint range of motion, promoting a prompt return to daily activities, and preventing complications associated with prolonged bed rest, such as pressure ulcers, deep vein thrombosis, and muscle atrophy. Due to her excellent recovery, she was discharged on the third day.

Obesity directly impacts the musculoskeletal system, subjecting it to immense mechanical load and heightened vulnerability. Excessive body weight elevates stress on joints, causing pain and discomfort—particularly in the knees, hips, and ankles—restricting mobility and increasing the risk of joint injuries.

Dr. Tang Ha Nam Anh further emphasized that overweight individuals should pursue gradual, sustainable weight management and undergo periodic comprehensive and musculoskeletal check-ups to monitor joint health. Regardless of preexisting conditions, maintaining a disciplined lifestyle with regular physical exercise and balanced nutrition is vital. Sustaining an optimal body weight remains key to safeguarding overall health and preventing pathologies, particularly musculoskeletal disorders.