Weight Changes After Knee Surgery: What to Know

Weight issues

Hello Doctor, my mother is about 60 years old and had knee replacement surgery earlier this year.
She is currently recovering well and can climb stairs.
The only medication she is taking now is one pill in the morning and one in the evening for blood pressure and heart rate.
However, it is strange that although her weight has not decreased (and she has even gained a kilogram or two), she looks significantly thinner (so much so that everyone notices and comments on it).
Since she just had knee surgery, she hasn't been exercising much, only taking slow walks twice a day.
Her activity level has decreased significantly, and her body feels soft without much muscle gain.
Is this considered normal, and should we just monitor her condition, or does she need to undergo further tests?

Jannie, 30~39 year old female. Ask Date: 2024/05/16

Dr. Li Jian reply Internal Medicine

If you are unsure about how to exercise appropriately, you can consult a rehabilitation specialist for therapy to prevent muscle atrophy.
Thank you for your inquiry.

Reply Date: 2024/05/16

More Info

After knee surgery, particularly total knee replacement, it is not uncommon for patients to experience unexpected changes in weight and body composition. Your mother's situation, where she has gained a couple of kilograms yet appears to have lost weight in terms of body shape, can be attributed to several factors related to the surgical recovery process.

Understanding Weight Changes Post-Surgery
1. Fluid Retention: After surgery, it is common for the body to retain fluids, especially in the lower extremities. This can lead to temporary weight gain. The body often retains fluid as part of the healing process, which can mask actual fat loss or muscle loss.
2. Muscle Atrophy: Post-surgery, especially if mobility is limited, muscle atrophy can occur. This means that while her overall weight may not have decreased, the muscle mass may have diminished, leading to a softer appearance. The loss of muscle can contribute to a feeling of being "soft" or less toned, even if the scale does not reflect a significant weight loss.

3. Dietary Changes: Changes in diet post-surgery, whether intentional or not, can also affect weight. If your mother is less active, she may not be burning as many calories, which could lead to weight gain if her caloric intake remains the same or increases.

4. Medication Effects: Some medications, particularly those for pain management or blood pressure, can lead to weight gain or fluid retention as a side effect. It’s essential to consider the medications she is currently taking and discuss any concerns with her healthcare provider.

5. Perception of Weight: Sometimes, the perception of weight loss can be influenced by changes in posture, swelling, or the way clothing fits after surgery. As she recovers and becomes more mobile, her body may redistribute weight differently, leading to a slimmer appearance despite the scale reading higher.

Recommendations
- Monitor Progress: It is crucial to continue monitoring her weight and overall health. If the weight gain continues or if there are concerns about her appearance or health, it would be wise to consult with her healthcare provider.

- Physical Activity: Encourage her to gradually increase her physical activity as advised by her rehabilitation team. Engaging in appropriate exercises can help rebuild muscle strength and improve overall body composition.

- Nutrition: A balanced diet rich in protein can help support muscle recovery and growth. Consulting with a nutritionist may provide tailored advice to ensure she is getting the necessary nutrients for recovery.

- Follow-Up Appointments: Regular follow-ups with her orthopedic surgeon or primary care physician are essential to address any concerns about her recovery, weight changes, or medication side effects.

Conclusion
In summary, your mother’s experience of gaining weight while appearing slimmer is not unusual after knee surgery. It is essential to consider factors such as fluid retention, muscle atrophy, dietary changes, and medication effects. While it may be normal, keeping an eye on her overall health and discussing any concerns with her healthcare provider is advisable. Encouraging gradual physical activity and a balanced diet will also support her recovery process.

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