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World J Orthop. May 18, 2023; 14(5): 294-301
Published online May 18, 2023. doi: 10.5312/wjo.v14.i5.294
Implications of obesity in patients with foot and ankle pathology
Hugo A Ubillus, Alan P Samsonov, Mohammad T Azam, Megan P Forney, Thelma R Jimenez Mosquea, Raymond J Walls
Hugo A Ubillus, Alan P Samsonov, Mohammad T Azam, Thelma R Jimenez Mosquea, Raymond J Walls, Department of Orthopedic Surgery, NYU Langone Health, New York City, NY 10002, United States
Megan P Forney, Department of Surgery, University of Cincinnati, Cincinnati, OH 45267, United States
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis; drafting, critical revision and editing; and approval of the final version.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Raymond J Walls, FRCS, MBChB, MD, Assistant Professor, Doctor, Staff Physician, Department of Orthopedic Surgery, NYU Langone Health, 171 Delancey Street, New York City, NY 10002, United States. raymond.walls@nyulangone.org
Received: November 8, 2022
Peer-review started: November 8, 2022
First decision: December 26, 2022
Revised: January 5, 2023
Accepted: March 20, 2023
Article in press: March 20, 2023
Published online: May 18, 2023
Abstract

Obesity is a growing problem defined as a body mass index of greater than 30 kg/m2. It is predicted that by 2030, 48.9% of adults will be classified as obese which expands surgical risk factors to a broad population while increasing healthcare costs at the same time in different socioeconomic groups. This specific population has been widely studied in multiple surgical fields and published studies have shown the implications in each of these fields. The impact of obesity on orthopedic surgical outcomes has been previously reported in several total hip and knee arthroscopy studies, with evidence indicating that obesity is strongly associated with an increased risk of post operative complications together with higher revision rates. In line with increasing interest on the impact of obesity in orthopedics, there has been a similar output of publications in the foot and ankle literature. This review article evaluates several foot and ankle pathologies, their risk factors associated with obesity and subsequent management. It provides an updated, comprehensive analysis of the effects of obesity on foot and ankle surgical outcomes, with the ultimate aim of educating both surgeons and allied health professionals about the risks, benefits, and modifiable factors of operating on obese patients.

Keywords: Obesity, Foot and ankle surgery, Ankle fracture, Total ankle replacement, Achilles tendinopathy, Hallux valgus

Core Tip: Obesity is a growing population. The impact of this is also reflected in fields such as Orthopedic Surgery including foot and ankle. Mobility is determinant in every aspect of life and in the obese population it reflects a greater challenge when addressing pathologies affecting the foot and ankle. Multiple factors can affect the outcomes of surgical treatments in this population and we believe that a greater understanding is needed to be prepared to treat these patients while trying to reduce the further complications that they face.