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My brother-in-law is very overweight. His knees are bad but he refuses to lose weight. He says he'll just have them replaced when they wear out. Is it really that simple?

The rising cost of health care has taken "simple" out of almost every picture today. Obesity is linked with degenerative disease of the hips and knees. A high body weight is also linked to a poor result after the joints are replaced.

A recent study at The Good Samaritan Hospital in Baltimore, Maryland compared total knee replacements (TKRs) in obese and nonobese adults. The patients all got the same joint implant (one that has been used successfully for many years).

Results were reviewed after five years. Being overweight had a negative impact on the success rate of TKRs. More implants failed in the obese group than in the nonobese group. Obese patients with failed implants had lower satisfaction rates.

There are improved medical treatments for obesity today. Encourage your brother-in-law to see his doctor and find out what are his options. He may be able to at least improve his health before his knees wear out and he faces the risks of surgery.

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