For most of her life, Susan wasn't overweight. But after she turned 50, that changed. She started gaining about 10 pounds every year. Within 10 years, she was 100 pounds overweight.
"That is what destroyed my knees," she said. "My right knee became bone on bone. One day, it just started hurting like hell."
So, Susan did something about it. (Her name has been changed for privacy reasons.) In November 2020, she got a total knee arthroplasty (TKA) at a hospital in central Connecticut. For a few months, she felt better. But the pain soon returned. Eventually, she learned that one of the prosthetic components in her knee replacement had loosened from the bone about four months after the surgery.
Studies show that people with higher body mass index (BMI) are more likely to experience serious complications both during and after joint replacement surgery. (Body mass index is a measure of body fat based on height and weight.) Because of this, many hospitals and surgeons now have BMI "cutoffs," limiting who is eligible for certain joint replacement surgeries.
For some patients, these cutoffs can mean being denied the orthopedic they need altogether. For others, like Susan, it can mean having surgeries in which there is an increased risk of failed prosthetics, infection, or other complications.
But a new kind of drug might close this gap: GLP-1s. Weight loss drugs like Ozempic and Zepbound can help patients who might otherwise not qualify for joint replacement surgeries have greater access to care - and undergo safer and more effective surgeries.
Susan, who is now 65, has lost 93 pounds since starting on the GLP-1. And working with her new care team at Yale - which includes experts in orthopedics and weight management - she is now preparing for a revision surgery of her right knee as well as a TKA of her left knee.
"I feel like I'm in good hands," she said. "I'm doing my part, and they're going to do their part. Together, we are going to get my knees back to when I was 45."
