Anyone had knee replacement despite a high BMI?

SoniaR

Hi all, had been taken off the knee replacement list (NHS) because my BMI is 40, despite having a very successful hip replacement at that BMI. Recovery was brilliant and no issues. My NHS consultant said the criteria for my trust for knee replacement had changed to exclude anyone with a BMI over 35. He actually said it was a cost cutting exercise and he would have happily done my surgery. This was in 2017. I know criterias seem to be different with each NHS trust. My osteoarthritis is now very severe and I’m in a lot of pain and cannot stand or walk for more than a few minutes. I use a mobility scooter to get about. My question is has anyone with a BMI of 40 ever had successful knee replacements and not be discriminated against?

I am seeing a nutritionist and have lost nearly a stone, which is great, but of course not being able to walk has limited my exercise capabilities. I rang my local private hospital and they said they would do the op at my BMI, so am contemplating this, but boy is it expensive! £17,000 per knee so I’m considering do Equity Release to pay for it. Would love to hear your experiences. Thank you.

CarolineW

Hi
Yes I had a knee replacement done 6 months ago and also have a BMI of 40. I am currently on an NHS waiting list for knee number 2 to be done. There has been no suggestion that I cannot have it done because of my BMI. It sounds like you are unlucky with where you live.
I did go privately for the first knee just because of the waiting list times and paid around £12000 in total so the quote you have for £17000 sounds really expensive. In my research for private options I did discover that providers like 'Spire' offer to allow you to pay over up to 6 years and so to spread the cost. It may be worth you doing a bit of research to see if there are options like that near to you. I do hope you find something that works for you…and good luck with the weight loss campaign too.

SoniaR

Thank you CarolineW. It’s as I suspected, a postcode lottery. I’m in Herts and I saw on tv a woman, much bigger than me, who was moaning about the waiting list for TKR in Cambs, My main point is she was on the list, whilst I’ve been taken off it! So unfair. The price in my area has gone up a lot since covid, but I like the surgeon I will be using and I like the hospital which is just up the road from me. Thank you again for your information, it has been a great help.

SoniaR

Firgot to say my private hospital has various payment schemes , but I’ve got the money to pay for it by doing an Equity Release, but I will look more into the payment schemes. Thank you.

Bryony

In my area North Yorkshire the BMI threshold is 30 in all the local CGC areas. Smokers are rejected. They even ask if you drink. As I don't drink any alcohol I don't know what happens to those who do say they drink alcohol. The only people I know who have had knee replacements all had to go private as they can't get onto the waiting lists. I'm still not on the waiting list - my BMI is fine, I don't smoke or drink. I've bone-on bone in both knees for at least 2 1/2 years, (severe pain began late 2019 but the covid pandemic meant I couldn't even get a face-to-face PT appointment till late 2021, and only got my first X-ray in early 2022). I haven't had an unbroken night's sleep due to knee discomfort since October 2020, but, hey, I can still put on my socks by myself and I don't have carers, and I can still wash myself without help, so I'm deemed not bad enough.

This is all about keeping people off the waiting lists so the waits don't look so bad, and to save money. It is very heavily rationed. If you finally get through the GP hurdles to be referred, the consultants then seem to cook up any reason to prevent you going on the waiting list, so as to break the referral to treatment clock, and so reset it. I dread to think the size of the waiting lists and waiting time lengths if all the people actually in need of knee replacements were on them.

At least going private you can choose a surgeon and are in reasonable control of the situation. Have you checked out the National Joint Registry, their Surgeon and Hospital Profile? It gives details of all the surgeons, the number of replacements they have done in the last 3 years (total and partial), the percentage of those with BMI 30+, plus other useful info.

SoniaR

Thank you Bryony, your comment has been most informative. I will have a peek at The National Joint Registry. I’ve had knee osteoarthritis since around 2007, had a hip replacement in 2016 (no BMI restrictions then) and been on the scrap heap since then. The consultant who did my hip said just that - the restrictions are there to reduce waiting lists and are just a cost cutting exercise. From the horses mouth! Now I am so disabled I can barely walk, use a mobility scooter and am on PIP benefits and have a blue badge. The pain is unbearable. Got an apt with private Orthopaedic consultant next week. He did an Arthroscopy on my knee years ago and he’s a lovely guy so I hope he will do them 🙏🙏🙏

SoniaR

NICE say there should no discrimination with age, sex, weight, race yet the NHS discriminates constantly.

Bryony

Yes, and there has been a long history of men getting referred for knee replacement whereas as women with the same degree of osteorthritis and severity of symptoms are denied it. This was shown in a paper in 2008 of Canadian patients and more recently in a paper in 2022 of Australian patients.

SoniaR

I can well believe that. Women are treated as if they are hysterical to complain about pain. My friend has Endometriosis, an incredibly painful womb disease. Took her 20 years to get diagnosed. Her medical notes said she had a very low pain threshold! When she was finally diagnosed the doctor held her hand and said my poor dear woman you must have suffered. Her pain was like giving birth every month when she had her period. Anyway I digress.

SoniaR

@Bryony I saw consultant yesterday (private) and he has booked me in for a knee replacement on 17 September! Yay! He said he has done it on several overweight people and have all been very successful. It could have been earlier but I need to sort a few things out as I am a carer for my husband and I’m searching for respite care for him whilst I recover. And got to find someone to feed my two little cats. I am over the moon.

Bryony

Excellent news! Just very sad for you that the NHS was not there for you when you needed them. and that you had to go private.