New rules for prosthetic surgery: what does BMI mean and how does it affect patients?
Author BMM | 2025.04.10.
In 2025, new regulations on hip and knee replacement surgery in the public health system will come into force, with major implications for patients waiting for prosthetic surgery. With the introduction of a body mass index (BMI) threshold, many patients could be taken off the waiting list. The aim of this article is to show why private hospital care may be a preferable alternative for many patients.
What is BMI and why is it important for prosthetic surgery?
BMI (body mass index) is a simple formula based measure of weight in relation to height:
BMI = body weight (kg) / body height² (m²)
This value helps to determine whether a person's weight is within the healthy range. The WHO (World Health Organization) uses the following categories:
- 18,5-24,9: normal weight
- 25-29,9: overweight
- 30-34,9: Stage I obesity
- 35-39,9: Stage II obesity
- Over 40: Grade III, severe obesity
The higher the BMI, the higher the health risk. In prosthetic surgery, overweight and obese patients are more likely to have surgical complications, such as:
- infections,
- wound healing problems,
- blood clots,
- anaesthesia risks,
- loosening or accelerated wear of the implanted prosthesis.
BMI is therefore of paramount importance for the safety and long-term success of surgery.
What has changed in public benefits in 2025?
As of 1 April 2025, the National Directorate General of Hospitals (NCDH) and the National Health Insurance Fund Management (NHIFM) have introduced a new protocol:
- Patients who have BMI over 35, not allowed on the waiting list for hip or knee replacement surgery.
- Those already on the list but above the threshold, can be temporarily deleted from the list until they lose weight.
The decision was justified on the grounds that it would reduce surgical complications and the risk of surgery.
What impact does this have on patients' lives?
The new rules could affect tens of thousands of middle-aged and elderly patients. Many of them have been living with pain and limited mobility for a long time, and prosthetic surgery would be the only permanent solution to their problem.
However, the introduction of new conditions causes serious difficulties:
- The difficulty of losing weight: Most patients waiting for a prosthesis have limited mobility, making it particularly difficult for them to lose weight.
- Loss of time: It can delay surgery by months or even years if you fail to lose the necessary weight in time.
- Pain and deteriorating quality of life: Postponing surgery also further reduces patients' quality of life, mobility and mental well-being.
Many people feel that this measure will force them out of the public health system.
What can you do if you are off the waiting list?
- Personalised weight loss: A diet designed with the help of a dietician, taking into account the patient's mobility limitations.
- Movement therapy: Gentle forms of exercise, such as aqua gymnastics, chair exercises, guided by a physiotherapist.
- Psychological support: Spiritual support for weight loss is key for many.
- Weight loss with medication or surgery: As a last resort, weight-loss medication or bariatric surgery may be considered on medical advice.
- Regular checks: Your GP or doctor can help you keep track of your BMI changes and reapply for a place on the waiting list.
The role and benefits of private hospitals
Many patients are turning to private hospital care as a result of the new state regulation, and there are several reasons for this:
1. More flexible conditions
Private institutions do not always use BMI limits as an exclusion factor. Of course, they take into account the risks of surgery, but they make their decisions on a case-by-case basis.
2. Shorter waiting times
While in the public system you may have to wait 1-2 years for a prosthetic operation, in private hospitals it can usually be done within a few weeks or months.
3. Advanced surgical technologies
Some private clinics, such as BMM, are using innovative solutions such as robot-assisted prosthesis implantation or muscle-sparing exploration, which result in faster recovery and fewer complications.
4. Personalised care
The patient is not just one of many, but at the centre: they receive detailed information, have more consultation with the doctor and receive full support from preparation to rehabilitation.
5. A better hospital environment
Modern, comfortable surroundings, double or single rooms, a more relaxed atmosphere, family-friendly attitude and hotel facilities - all this reduces stress and improves the recovery experience.
Why choose a private hospital?
The Budapest LIV Duna Medical Center One of Hungary's most modern private hospitals, providing an outstanding standard of orthopaedic care for patients undergoing hip and knee replacement surgery. At the hospital, BMM's experienced and internationally renowned surgeons perform procedures using state-of-the-art technologies, including robotic-assisted surgical systems. Our aim is to provide safe, personalised and fast care with short waiting times and full patient journey management, making us the ideal solution for those who cannot get to their appointments on time due to public care restrictions.
What can people waiting for prosthesis surgery do today?
- It is worth checking your own BMI - and if it's over 35, start consciously losing weight.
- Consult your GP or orthopaedic specialist - whether in the public or private sector.
- Consider private hospital care, especially if the pain is severe and the limitation of movement is significant.
- Move towards your goal with awareness and patience - preparation is as important to the success of prosthetic surgery as the procedure itself.
The role of BMI, the body mass index, in prosthetic surgery planning is now not only of medical but also of strategic importance. For those involved, it is important to be aware of the options so that they can make a responsible decision for their own health and future - whether they choose public or private care.