tant, if not the most
important, thing."
Activity level
and BMI
There's no hard-and-
fast rule about a BMI
threshold for joint
replacement. "Obesity
in this country is a
problem," says Richard
G. Buch, MD, orthope-
dic surgeon at The
Dallas (Texas) Limb
Restoration Center.
"That makes it hard to
use BMI as a selection
tool. By national stan-
dards, anyone who is
over 30 BMI is consid-
ered obese, but that would eliminate nearly half of the entire popula-
tion."
Instead, rely on a combination of BMI and activity level to make the
final decision. "Typically if the BMI is over 35, I'm less likely to choose
them, and especially if it's over 40," says Dr. Buch. "But it depends on
the patient. Someone might be bigger, but also very active."
"Quite frankly, I look for a lower weight," adds Dr. Caillouette. "I
typically have a BMI cutoff of 36. Now, that doesn't mean it's impossi-
ble to operate on patients with higher BMIs — I've performed proce-
dures on patients who are 6'8 and 300 pounds in an ASC. But they
J A N U A R Y 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 1 9
• READY AND WILLING Patients must be healthy enough to recover quickly from complex procedures.
The
Dallas
Limb
Restoration
Center
