Prophylactic Tibial Stem Fixation in the Obese: Comparative Early Results in Primary Total Knee Arthroplasty
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Purpose: Obesity is a risk factor for aseptic loosening after total knee arthroplasty (TKA). Prophylactic use of tibial stems may enhance tibial fixation in obese patients. The aim of this study was to determine whether a tibial stem extension decreases rates of early failure in obese patients.Materials and Methods: This study included 178 consecutive primary TKAs (143 patients) with a body mass index ≥35 kg/m2. Fifty TKAs were performed with the use of a 30 mm tibial stem extension, and 128 TKAs were performed with a standard tibial component. Patients with twoyear clinical followup were included. The primary outcome was revision for aseptic loosening. Secondary outcomes were allcause revision and radiolucent lines (RLLs) on radiographs. Results: Average followup was 34 months (range, 24 to 46 months). No failures for aseptic loosening occurred. The occurrence of secondary procedures was not significantly different between groups. Quantification of RLLs revealed no difference between groups.Conclusions: At early followup, no difference was measured in revision rates, need for subsequent procedures, or RLLs between groups.
Abstract
Purpose: Obesity is a risk factor for aseptic loosening after total knee arthroplasty (TKA). Prophylactic use of tibial stems may enhance tibial fixation in obese patients. The aim of this study was to determine whether a tibial stem extension decreases rates of early failure in obese patients.Materials and Methods: This study included 178 consecutive primary TKAs (143 patients) with a body mass index ≥35 kg/m2. Fifty TKAs were performed with the use of a 30 mm tibial stem extension, and 128 TKAs were performed with a standard tibial component. Patients with twoyear clinical followup were included. The primary outcome was revision for aseptic loosening. Secondary outcomes were allcause revision and radiolucent lines (RLLs) on radiographs. Results: Average followup was 34 months (range, 24 to 46 months). No failures for aseptic loosening occurred. The occurrence of secondary procedures was not significantly different between groups. Quantification of RLLs revealed no difference between groups.Conclusions: At early followup, no difference was measured in revision rates, need for subsequent procedures, or RLLs between groups.
참고문헌 (18)
- Abdel MP, "Increased aseptic tibial failures in patients with a BMI <TEX>${\geq}$<", TEX>35 and well-aligned total knee arthroplasties, 2015, pp.30, 2181~2184
- Lim CT, "Weight gain after primary total knee arthroplasty is associated with accelerated time to revision for aseptic loosening", J Arthroplasty, 32, pp.2167~2170 (2017)[DOI]
- Lubbeke A, "Body mass and weight thresholds for increased prosthetic joint infection rates after primary total joint arthroplasty", Acta Orthop, 87, pp.132~138 (2016)[DOI]
- Samson AJ, "Total knee replacement in the morbidly obese: a literature review", ANZ J Surg, 80, pp.595~599 (2010)[DOI]
- Odum SM, "National obesity trends in total knee arthroplasty", J Arthroplasty, 28(8 Suppl), pp.148~151 (2013)[DOI]
- Ogden CL, "Prevalence of childhood and adult obesity in the United States, 2011-2012", JAMA, 311, pp.806~814 (2014)[DOI]
- [URL]
- Bozic KJ, "Comparative epidemiology of revision arthroplasty: failed THA poses greater clinical and economic burdens than failed TKA", Clin Orthop Relat Res, 473, pp.2131~2138 (2015)[DOI]
- Sharkey PF, "Why are total knee arthroplasties failing today: has anything changed after 10 years?", J Arthroplasty, 29, pp.1774~1778 (2014)[DOI]
- Fehring TK, "Catastrophic varus collapse of the tibia in obese total knee arthroplasty", J Arthroplasty, 32, pp.1625~1629 (2017)[DOI]
- Parratte S, "Do Stemmed tibial components in total knee arthroplasty improve outcomes in patients with obesity?", Clin Orthop Relat Res, 475, pp.137~145 (2017)[DOI]
- Berend ME, "Implant migration and failure in total knee arthroplasty is related to body mass index and tibial component size", J Arthroplasty, 23(6 Suppl 1), pp.104~109 (2008)[DOI]
- Ries C, "Short-keeled cemented tibial components show an increased risk for aseptic loosening", Clin Orthop Relat Res, 471, pp.1008~1013 (2013)[DOI]
- Ewald FC, "The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system", Clin Orthop Relat Res, (248), pp.9~12 (1989)
- Chalmers BP, "A novel percentage-based system for determining aseptic loosening of total knee arthroplasty tibial components", J Arthroplasty, 32, pp.2274~2278 (2017)[DOI]
- Ecker ML, "Long-term results after total condylar knee arthroplasty. Significance of radiolucent lines", Clin Orthop Relat Res, (216), pp.151~158 (1987)
- Bach CM, "Reproducible assessment of radiolucent lines in total knee arthroplasty", Clin Orthop Relat Res, (434), pp.183~188 (2005)
- Seong SC, "Clinical and radiological results of total knee arthroplasty with a system of asymmetric tibial tray", J Korean Knee Soc, 12, pp.151~158 (2000)