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Obese patients ‘penalised’ by knee surgery rules



Obese patients are being unfairly ‘penalised’ when they are blocked from having a knee replacement as their improvement after surgery is equivalent to those with a ‘normal’ weight, researchers have concluded.   

Using national patient-reported outcome measures (PROMS) data, the researchers found although obese patients had lower scores overall, they showed an equivalent improvement in scores after surgery.

Pulse revealed last year that LMC and CCG leaders
had backed moves by NHS Hertfordshire to block any patient with a BMI over 30 from being referred for joint replacement surgery unless they took part in a weight-loss schedule.

UK researchers looked at data from 13,600 patients who underwent a knee replacement between May 2008 and September 2010.

They found the change in preoperative and postoperative PROM scores was equivalent in both groups of patients, with a change in knee health score of 16 in the obese group and 15.7 in the normal weight group.

Writing in the Journal of Bone and Joint Surgery last month, the authors concluded: ‘It is important that those in control of healthcare resources do not penalise obese patients on the basis of the limited functional outcome data available from previous studies.’

Dr Sally Hope, a GP in Woodstock, Oxfordshire, and a member of NICE’s hip fracture guideline committee, said: ‘This paper will be helpful in appeals.’