Obesity and the Upper Limb

This chapter will explore the relationship between obesity and total shoulder arthroplasty (TSA) and total elbow arthroplasty (TEA), as well as the associated risks, complications, and impact on both surgeons and patients. While the connection between obesity and osteoarthritis of the lower limb is well documented, less research is available regarding the upper limb. The current knowledge surrounding obesity and its implications in TSA and TEA will be scrutinised and unanswered questions will be highlighted. Here, the demographics of shoulder and elbow arthroplasty patients are discussed, with a focus on the increasing rates of arthroplasty procedures and the rising prevalence of obesity. Potential implications of obesity on surgical goals and functional outcomes are examined, including the impact of obesity on range of motion, pain levels, and quality of life. Intraoperative challenges in obese patients are explored, such as increased operating time, blood loss, and the need for proper pain control and anaesthesia management. The postoperative complications for TSA and TEA in obese patients, including an increased risk of venous thromboembolism, infections, respiratory complications, revision rates, and longer hospital stays, are also outlined. Despite these challenges, evidence suggests that obese patients can still expect improvement in functional outcomes and quality of life following surgery. Overall, this chapter provides an overview of the current understanding of the relationship between obesity and TSA/TEA, highlighting the need for further research to better inform surgical decision-making and patient care.