Metabolic syndrome is typically defined as the constellation of 3 out of 4 medical conditions frequently found in association: diabetes (HgbAIC >7.0), dyslipidemia (cholesterol >200), obesity (BMI > 30) and hypertension (SBP > 140, DBP >90). Metabolic syndrome has been increasing in TJA and is estimated in 14% of TKA, and 10% of THA.
Obesity is often the tip of this iceberg, the visible aspect of a medical unhealthiness that runs far deeper.
In obese patients, a full work up of associated medical conditions, particularly those associated with metabolic syndrome. Interestingly, when a patient with metabolic syndrome has all of these comorbidities well controlled, the rate of complications approaches a the control group (overall complication about 8%) while poorly controlled comorbidities (even just one uncontrolled aspect of metabolic syndrome) leads to dramatically higher complication rates (49%) .
1. Zmistowski, B., et al., Patients with uncontrolled components of metabolic syndrome have increased risk of complications following total joint arthroplasty. J Arthroplasty, 2013. 28(6): p. 904-7.