Management of symptomatic knee osteoarthritis in obesity: a survey of orthopaedic surgeons' opinions and practice

The aim of this survey was to explore knee surgeons’ opinions and practices regarding the management of symptomatic knee osteoarthritis in obesity. Questionnaires were sent electronically to all consultant members of the British Association for Surgery of the Knee. The response rate was 52%. The survey showed considerable practice variation and divided opinion on the evidence base. The majority stated that weight loss should be the first-line treatment. 53% (91/172) stated that such cases should ideally be assessed by a specialist multidisciplinary service; however, only 24% (41/169) would be interested in being the orthopaedic surgeon in such a service. The optimal pathway of care for the obese patient with symptomatic knee osteoarthritis remains unclear. Given recent debate around the rationing of knee arthroplasty surgery in obesity, we felt it was timely to survey knee surgeons’ current practice. Our survey has shown considerable variation in the opinions and practice of surgeons on the management of symptomatic knee osteoarthritis in obesity, together with divided views on current literature.