[Current AWMF guidelines on knee and hip arthroplasty - individual risks].

Area of Science:

• Orthopedic Surgery
• Public Health
• Medical Guidelines

Context:

• Over 300,000 primary hip and knee arthroplasties were performed in Germany in 2022.
• Increasing surgical numbers correlate with a rise in potential postoperative complications.
• International data aids in identifying risk factors for these complications.

Purpose:

• To highlight the importance of managing modifiable risk factors in arthroplasty surgery.
• To emphasize the focus of German orthopedic professional societies on factors like obesity, diabetes mellitus, and smoking.
• To review current guidelines regarding obesity and arthroplasty.

Summary:

• German guidelines recommend weight loss for patients with a Body Mass Index (BMI) > 30 kg/m² prior to knee and hip arthroplasty.
• A BMI ≥ 40 kg/m² is considered a relative contraindication, necessitating careful risk-benefit assessment.
• Shared decision-making is crucial for obese patients undergoing arthroplasty.

Impact:

• Effective management of modifiable risk factors can decrease the incidence of postoperative complications.
• This approach supports patient safety and optimizes outcomes in joint replacement surgery.
• Promoting weight loss and informed decision-making can improve the success rate of arthroplasty procedures.