Background In the United States, the obese population has increased markedly over the last four decades, and this trend continues. High patient weight places additional stress on TKAcomponents, which may lead to increased polyethylene wear, osteolysis, radiolucencies, and clinical failure. Metalbacked tibial components and all-polyethylene tibial components in the general population have comparable osteolysis and failure, but it is unclear whether these components yield similar osteolysis and failure in obese patients. Questions/purposes We therefore determined the (1) function, (2) occurrence of osteolysis, and (3) complications in a cohort of obese patients receiving allpolyethylene tibial components. Patients and Methods Between September 17, 1996, and December 19, 2002, we implanted all-polyethylene tibial components in 90 obese patients (125 knees); 24 patients (33 knees) died and 13 patients (17 knees) were lost to followup, leaving 53 patients (59%) with 75 knees. All surgeries were cruciate-retaining, tricompartmental TKAs. We evaluated patients with Knee Society Scores and serial radiographs. Minimum followup was 7 years (mean, 10.4 years; range, 7-14 years). Results At latest followup, mean Knee Society Score was 92 points. There were five tibial radiolucencies, all less than 1 mm and characterized as nonprogressive. We observed minimal, nonprogressive osteolysis in one knee. One patient required reoperation after a traumatic event. There were no implant-related failures and no implants at risk of failure. Conclusions At an average 10-year followup, allpolyethylene tibial components were functioning well in this obese group. These findings confirm the effectiveness of all-polyethylene tibial components in obese patients. Level of Evidence Prognostic-Level IV-Case Series, uncontrolled. See Guidelines for Authors for a complete description of levels of evidence.
ASJC Scopus subject areas
- Orthopedics and Sports Medicine