BMI as an Eligibility Criterion for Hip or Knee Replacement

Orthopedists increasingly require patients to meet various criteria (e.g., body-mass index [BMI] or glycosylated hemoglobin below a certain threshold) before proceeding with total hip or knee arthroplasty; the rationale is to minimize complication rates. In this study, U.S. researchers used a veterans' healthcare database to estimate the tradeoffs if access to joint replacement were denied at various BMI thresholds.

Among nearly 28,000 patients who underwent hip or knee arthroplasty, the overall 30-day rate of major complications (e.g., cardiopulmonary, infectious, hemorrhagic) was 5.05%. Among the roughly 1200 patients with BMI ≥40 kg/m², the major-complication rate was 6.74%. If patients with BMI ≥40 had not been permitted to undergo surge…