The normal BMI is 18 to 24, while under 18 is described as being a low body mass index. People who have higher BMIs are divided into an overweight class from 25 to 29, an obese class from 30 to 39, and a morbidly obese class over 40.
Orthopaedic surgeons are concerned with body mass index as it relates to multiple common problems in orthopaedics. An obvious implication of increased weight can be the tendency for increased wear of particularly the weight-bearing joints. Our joints are covered with an antifriction layer, which is called hyaline cartilage. With time this wears in all individuals. This process is often called osteoarthritis. There are other arthritic conditions that may have higher or lower rates of wear that are based on other causes. This wear process is related to your specific impact profile. Depending on what type of activities each person is involved in while at home, while at work, or recreationally, taken together, they constitute the force that the body tries to absorb and minimize. A carefully organized exercise program that has the three components of flexibility, muscle strengthening, and balanced-impact aerobic activities often is the best way to minimize the wear process.
For those patients who have an elevated BMI, we strongly recommend that you contact your primary care physician in order to create a comprehensive plan to minimize and hopefully reduce your BMI. This may include an analysis of your dietary intake and recommendations for an evaluation by a dietician as well as recommendations for a safely tolerated exercise program. Patients who have elevated BMIs often have associated conditions including high blood pressure, diabetes, and heart disease, which can directly influence your ability to perform an exercise program. It is crucial that you discuss with your primary care physician your ability to perform exercises based on your specific medical history and possible medical problems. As orthopaedic surgeons, we are aware that elevated BMIs cause an increased risk of complications during surgery including anesthesia risk, length of operative times, infections, wound-healing problems, breathing problems, blood clots, and embolus. It is often necessary for us as surgeons to include your primary care physician in your surgical treatment plans to minimize these risks. These comments are given as general recommendations. Please contact your primary care physician or care provider to discuss your BMI and its best treatment.