# Reassessing BMI-based access to joint replacement surgery

## TL;DR

This paper argues that using BMI alone to restrict access to joint replacement surgery is not supported by evidence and can cause harm and inequality.

## Contribution

The paper challenges the use of BMI as a sole criterion for surgery access and highlights its potential for harm.

## Key findings

- Restricting surgery based on BMI lacks strong evidence of safety or benefit.
- Such restrictions may worsen stigma and health inequities.
- Patients with higher BMI can still benefit meaningfully from joint replacement.

## Abstract

Joint replacement surgery transforms lives for patients with higher body mass index (BMI). Strong evidence shows safe outcomes and meaningful benefit, yet access remains restricted by BMI alone, an approach that risks stigma, inequity, and avoidable harm.

In this Perspective, Jonathan Evans and colleagues discuss why restricting access to joint replacement surgery based on BMI alone is not supported by evidence, and highlight how such restrictions risk exacerbating stigma, inequity and avoidable harm to those who would benefit from surgery.