NEW DELHI: In a case that challenged conventional concerns about obesity and joint replacements, a 58-year-old Kalkaji resident weighing 125kg successfully underwent a total hip replacement (THR) procedure after being diagnosed with avascular necrosis (AVN), a condition in which bone tissue dies due to a lack of blood supply.
THR is a common orthopaedic procedure in which the damaged parts of the hip joint are replaced with artificial components. It is often recommended in cases of advanced arthritis, injury or AVN when conservative treatments fail. While obesity has traditionally been considered a risk factor in joint replacement surgeries, orthopaedic specialists say successful outcomes are increasingly being reported in heavier patients.In this case, Sameer Kapoor underwent surgery at Fortis Escorts Hospital in southeast Delhi’s Okhla, where a team led by senior orthopaedic surgeon Dr Kaushal Kant Mishra performed the procedure on June 16. Kapoor, a medical shop owner, was suffering from severe hip pain and restricted mobility for several months.“Operating on patients weighing above 100kg presents challenges, including positioning, longer surgical time and an increased risk of infection,” said Dr Mishra. “But obesity alone shouldn’t prevent a patient from getting timely care. In this case, early intervention helped prevent permanent disability. If left untreated, the patient would have continued to suffer from chronic pain, limping, osteoporosis, and secondary spinal degeneration.“Post-surgery, the patient began walking with support and is already showing signs of weight loss. Kapoor told TOI that Kapoor’s weight dropped from 125kg to 123.3kg in the first week itself before declining further to 119.2kg by the third week. Currently, it is 115kg.Other orthopaedic experts confirmed that similar surgeries had been performed on even heavier patients. “Several such procedures have been carried out on individuals weighing well above 100kg, even up to 150kg,” said Dr Ramneek Mahajan, chairman, orthopaedics, and chief of robotic joint replacement, Max Hospital, Saket. “Many of these cases go undocumented, but advances in robotics, surgical techniques and implant design have made joint replacements safer and more reliable, regardless of weight.“However, not all experts agree that proceeding directly to surgery is always the best course. Dr J Maheshwari, senior orthopaedic surgeon, Sitaram Bhartia Hospital, advised obese patients to consider weight loss before undergoing joint replacement. “It’s better to reduce weight before a major joint replacement surgery. In some cases, bariatric surgery or medically supervised weight loss can help minimise complications and improve long-term outcomes,” he said.According to Dr Mishra, the procedure was technically challenging, with a surgical depth of nearly 10 inches – much more than the usual 2-3 inches. He noted that while obesity increased surgical risks, outcomes largely depended on the patient’s overall fitness and accurate implant placement, which are crucial for recovery and long-term joint function.The surgeon added that complications could occur at different stages: early (within 15 days), may include infection, dislocation, or nerve injury; intermediate (three weeks-three months), may involve limb swelling or changes in gait; and delayed complications (after six months), though rare, can result in permanent gait abnormalities or limb length discrepancies.
