"The Best Knee Replacement Alternative for Osteoarthritis Treatment"
The largest study in history on the health effects of being overweight,
analyzing data from more than 50 million people from
nearly 200 countries, found that excess body weight accounts for
the premature deaths of about 4 million people every year.
Most of these deaths are from heart disease,
but the researchers found “convincing” or “probable” evidence
linking obesity to twenty different disorders—
a veritable alphabet soup of potential health concerns.
In the ABCs of health consequences, A is for arthritis.
Obesity can make rheumatoid arthritis worse and increase the risk
of another inflammatory joint disease,
the so-called “disease of kings,” gout.
The most common joint disease in the world, though, is osteoarthritis,
and obesity may be the main modifiable risk factor.
Osteoarthritis develops when the cushioning-cartilage-lining
of joints breaks down faster than your body can build it back up.
The knees are the most commonly affected, leading to the assumption
that the relation to obesity was simply the excess wear and tear
from the added load on the joints.
But, non-weight-bearing joints like the hands and wrists
can also be affected, suggesting the link isn’t purely mechanical.
Obesity-related dyslipidemia may be playing a role,
with elevations in the amounts of triglycerides, fat, and cholesterol
in the blood aggravating inflammation in the joints, just like
cholesterol can aggravate the inflammation in your artery walls.
Osteoarthritis sufferers not only have higher cholesterol levels
in the blood, they have higher cholesterol levels within their joints,
both in aspirated joint fluid and in the cartilage itself.
Drip cholesterol on human cartilage in a petri dish
and you can worsen the inflammatory degeneration, helping to explain
why the higher people’s cholesterol the worse their disease.
Cholesterol-lowering statin drugs may both help prevent and treat
osteoarthritis, as can a cholesterol-lowering diet.
A healthy enough plant-based diet may offer the best of both worlds,
dropping cholesterol as much as a starting dose of a statin drug—
within a single week—and only has good side effects such as
lowering blood pressure and facilitating weight loss.
Even just losing about a pound a year over the span of a decade
may decrease the odds of developing osteoarthritis by more than 50%.
Weight reduction may even obviate the need for knee-replacement surgery.
Obese osteoarthritis sufferers randomized to lose weight
improved their knee function as much as those going through surgery,
within just eight weeks.
The researchers conclude that losing 20 pounds of fat
“might be regarded as an alternative to knee replacement.”
Isn’t it easier to just get your knees replaced than lose 20 pounds?
Rarely discussed is the fact that nearly 1 in 200
knee replacement patients, die within 90 days of surgery.
Given the extreme popularity of this operation—about 700,000 a year
in the US—an orthopedics journal editor suggested that
“people considering this operation are inadequately attuned
to the possibility that it may kill them.”
Arguably, the “single most salient fact” to share
with a patient considering the operation.
An orthopedic surgeon responded questioning whether patients
should be told about the chance the operation may kill them, quote:
“To me, the real question is whether this knowledge
will help the patient. Will it add to the anxiety
of the already-anxious patient, perhaps to the point of denying
that patient a helpful operation?
Or will this knowledge motivate a less-handicapped patient
to stick to a diet and physical activity regime?
Ultimately, then, the question boils down
to the surgeon’s judgment,” unquote.
Even among the vast majority who survive the surgery,
approximately one in five knee replacement patients
describe being unsatisfied with the outcome.
Weight loss with a healthy diet, on the other hand,
may offer a nonsurgical alternative that instead
treats the cause and offers only beneficial side effects.