[Locomotor handicap and obesity]

Obesity and osteoarthritis are frequently associated, particularly in older patients. Obesity increases the relative risk to develop knee or hip osteoarthritis, mainly in case of early obesity. This relative risk to develop osteoarthritis increases with body mass index, particularly in women. Early management of obesity, even a moderate weight loss, decreases the risk to develop knee osteoarthritis. Therapeutic management of obese patients is not different from those of non-obese patients; however, it is essential to integrate weight loss within the therapeutic project. Obesity should not be a contraindication to total knee or hip replacement, but weight loss has to be part of the pre- and post surgical management program of the obese patient.