Knee Surg Relat Res.  2018 Sep;30(3):227-233. 10.5792/ksrr.18.022.

Prophylactic Tibial Stem Fixation in the Obese: Comparative Early Results in Primary Total Knee Arthroplasty

• Steere JT
• Sobieraj M
• DeFrancesco CJ
• Israelite
• Nelson CL
• Kamath AF

• KMID: 2420348
• DOI: http://doi.org/10.5792/ksrr.18.022

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 two-year clinical follow-up were included. The primary outcome was revision for aseptic loosening. Secondary outcomes were all-cause revision and radiolucent lines (RLLs) on radiographs.
RESULTS
Average follow-up 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 follow-up, no difference was measured in revision rates, need for subsequent procedures, or RLLs between groups.

Keyword

Knee; Obesity; Arthroplasty; Stem

MeSH Terms

Arthroplasty
Arthroplasty, Replacement, Knee*
Body Mass Index
Follow-Up Studies
Humans
Knee
Obesity
Risk Factors