The Outcome of Total Knee Arthroplasty in Obese Patients

Foran, Jared R.H.; Mont, Michael A.; Etienne, Gracia; Jones, Lynne C.; Hungerford, David S.

doi:10.2106/00004623-200408000-00002

Cited by 265 publications

(207 citation statements)

References 22 publications

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“…Apart from the material and shape of the implants, it has been apparent that precise positioning is essential regarding long-term survival [3,5,11,15]. It is not always a simple goal to achieve, e.g., in cases of severe varus or valgus deformity, or extreme obesity of the patient [6]. The suboptimal lower limb axis or rotational malposition of components results in uneven load bearing, impairment of soft tissue balance, and ultimately in serious wear of polyethylene and early component loosening.…”

Section: Discussionmentioning

confidence: 99%

Experiences with computer navigated total knee arthroplasty

Bejek

Sólyom

Szabó

2006

International Orthopaedics (SICO

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The successful outcome of total knee arthroplasty (TKA) is very much dependent on precise positioning of the components. Inaccuracy may result in complaints as well as in early mechanical failure. Between March 2003 and September 2005, 69 TKA procedures were performed by the computer navigated technique. The postoperative outcome of this cohort was compared with the same number of TKAs done by the traditional technique. The lower limb anatomical axis was determined in all cases preand postoperatively by weight-bearing anteroposterior (AP) and lateral full length X-rays. The positions of femoral and tibial components were recorded. Comparing the data in the navigation group on the AP view, 96.6% of femoral and 96.9% of tibial components and on the lateral view in 95.4% of femoral and in 95.4% of tibial components, the overall postoperative axis in 95.4% fell in the range considered in the literature as optimal. In the traditional group on the AP view, 75.7% of femoral and 68.1% of tibial components and on the lateral view 81.8% of femoral and 63.6% of tibial components, the overall postoperative axis in 60.6% fell between the values considered optimal in the literature. It seems to be proven that the computer navigated total knee arthroplasty technique ensures positioning of components significantly more precisely compared with the traditional surgical method. Accuracy of navigation depends on the software used, on the correct detection of anatomical reference points, and on a potentially uneven thickness of the cement layer during final insertion of the components. The computer navigated technique does not substitute professional skill and experience, since it merely transmits information for the surgeon. The decision is in the hands of the doctor during the entire procedure. The real benefits of the computer navigated technique require further research and can be determined only after long-term analyses. Résumé Le succés de l'arthroplastie totale de genou dépend beaucoup du positionnement des implants. Entre mars 2003 et septembre 2005, 69 athroplasties étaient réalisées avec une technique de navigation informatique. Le devenir de ce groupe était comparé avec le même nombre d'arthroplasties faites avec la technique traditionnelle. L'axe anatomique du membre inférieur était déterminé par des radiographies antéro-postérieures en charge et de profil en extension. Dans le groupe navigué, la position des implants était optimale sur les radio de face pour 96,6% des pièces fémorales, 96,9% des pièces tibiales, sur les radio de profil pour 95,4% des pièces fémorales et tibiales, avec un bon axe dans 95,4% des cas. Dans le groupe traditionnel, les chiffres étaient: 75,7% pour les pièces fémorales, 68,1% pour les pièces tibiales sur les radio de face et 81,8% pour les pièces fémorales, 63,6% pour les pièces tibiales sur les radio de profil avec un bon axe dans 60,6% des cas. Il semble prouvé que l'utilisation de la navigation informatique permette un meilleur positionnement des implants que la méthode convention...

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Section: Discussionmentioning

confidence: 99%

Experiences with computer navigated total knee arthroplasty

Bejek

Sólyom

Szabó

2006

International Orthopaedics (SICO

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“…Obese patients are more likely to have medical problems and complications related to orthopedic surgery. There is an increased incidence of elevated blood lipids, steatohepatitis, and cholelithiasis in obese children [4,10]. Obese children show a predisposition to increased glucose tolerance and contribute significantly to the rising number of noninsulin-dependent diabetes mellitus diagnoses [10].…”

Section: Discussionmentioning

confidence: 99%

“…There is an increased incidence of elevated blood lipids, steatohepatitis, and cholelithiasis in obese children [4,10]. Obese children show a predisposition to increased glucose tolerance and contribute significantly to the rising number of noninsulin-dependent diabetes mellitus diagnoses [10]. It has been reported that nearly a third of obese children suffer from hypertension, which, when coupled with elevated blood lipids, places these children at risk for coronary heart disease [10].…”

Section: Discussionmentioning

confidence: 99%

“…Obese children show a predisposition to increased glucose tolerance and contribute significantly to the rising number of noninsulin-dependent diabetes mellitus diagnoses [10]. It has been reported that nearly a third of obese children suffer from hypertension, which, when coupled with elevated blood lipids, places these children at risk for coronary heart disease [10]. It has also been reported that obese children suffer more often from sleep apnea and, possibly, a related diminution of learning and memory function than their non-obese peers [4,10].…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported that nearly a third of obese children suffer from hypertension, which, when coupled with elevated blood lipids, places these children at risk for coronary heart disease [10]. It has also been reported that obese children suffer more often from sleep apnea and, possibly, a related diminution of learning and memory function than their non-obese peers [4,10]. Foran et al [4,10] have shown that obesity correlates with a worse outcome following total knee arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

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Complications with flexible nailing of femur fractures more than double with child obesity and weight >50 kg

Weiss

Choi

Ghatan

et al. 2009

Journal of Children's Orthopaedics

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Background Previous studies report that children above the 95th percentile in weight for their age had an increased risk for complications following titanium elastic nailing for femur fractures. The purpose of this study is to examine whether obesity, defined as body mass index (BMI) [ 95th percentile, and/or simple weight correlates with an increased rate of complications. Methods The incidence of complications was compared between obese and non-obese patients and also between patients who weighed C50 kg and those \50 kg. Results The overall complication rate was 23% (16/71). The complication rate was 17% (10/58) for ''non-obese'' patients and 46% (6/13) for ''obese'' patients. This difference was statistically significant (P = 0.03). The complication rate was 46% (6/13) in children who weighed C50 kg and 17% (10/58) in children who weighed\50 kg. This difference was also statistically significant (P = 0.03). Conclusions This study demonstrates that obesity (BMI [ 95th percentile) and weight over 50 kg predispose patients to increased risk of surgical complications when undergoing flexible elastic nailing for femur fractures. Both obese children and children weighing C50 kg were two times more likely to have a complication when undergoing this procedure.

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Effect of Bariatric Surgery on Risk of Complications After Total Knee Arthroplasty

et al. 2022

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Key Points Question Does bariatric surgery reduce complication risk after total knee arthroplasty (TKA) in patients with severe obesity? Findings In this randomized clinical trial of 82 adults aged 65 years and younger with class II obesity, those who were scheduled to undergo TKA experienced fewer joint surgery complications after undergoing a bariatric procedure, compared with those who underwent TKA without weight loss intervention. Meaning The findings suggest that people with severe obesity and knee osteoarthritis should seek to lose weight before considering TKA, and weight loss appears to reduce the complications of joint surgery.

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The Outcome of Total Knee Arthroplasty in Obese Patients

Cited by 265 publications

References 22 publications

Experiences with computer navigated total knee arthroplasty

Experiences with computer navigated total knee arthroplasty

Complications with flexible nailing of femur fractures more than double with child obesity and weight >50 kg

Effect of Bariatric Surgery on Risk of Complications After Total Knee Arthroplasty

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