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Relationship between obesity and early failure of total knee prostheses

BACKGROUND: Obesity is a risk factor for knee arthritis. Total knee arthroplasty is the definitive surgical treatment of this disease. Therefore, a high percentage of subjects treated are overweight. Since 2000 in the Emilia-Romagna Region the Register of Orthopedic Prosthetic Implantology, RIPO, ha...

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Autores principales: Bordini, Barbara, Stea, Susanna, Cremonini, Sara, Viceconti, Marco, De Palma, Rossana, Toni, Aldo
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2660896/
https://www.ncbi.nlm.nih.gov/pubmed/19265522
http://dx.doi.org/10.1186/1471-2474-10-29
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author Bordini, Barbara
Stea, Susanna
Cremonini, Sara
Viceconti, Marco
De Palma, Rossana
Toni, Aldo
author_facet Bordini, Barbara
Stea, Susanna
Cremonini, Sara
Viceconti, Marco
De Palma, Rossana
Toni, Aldo
author_sort Bordini, Barbara
collection PubMed
description BACKGROUND: Obesity is a risk factor for knee arthritis. Total knee arthroplasty is the definitive surgical treatment of this disease. Therefore, a high percentage of subjects treated are overweight. Since 2000 in the Emilia-Romagna Region the Register of Orthopedic Prosthetic Implantology, RIPO, has recorded data of all the primary and revision operations performed on the knee; height and weight of patients at the time of surgery have also been recorded. METHODS: To understand how overweight and obesity affect the outcome of knee arthroplasty, a population of subjects treated with cemented total knee arthroplasty between 2000 and 2005 was studied. 9735 knee prostheses were implanted in 8892 patients; 18.9% of the patients were normal weight, 48.2% were overweight (25 < Body Mass Index <= 30), 31.1% were obese (30 < BMI <= 40), and 1.8% were morbidly obese (BMI > 40). Mean and range of follow-up were respectively 3.1 and 1.5–6 yrs. Implant failure was defined as the exchange of at least one component for whatever reason. RESULTS: In normal weight patients there were 36 failures out of 1840 implants (1.96%), in overweight patients there were 87 out of 4692 (1.85%), in obese 59 out of 3031 (1.94%), and in morbidly obese there were 4 out of 172 (2.3%). The mean time to failure for each class was 1.57, 1.48, 1.60, 1.77 yrs. Cox regression analyses showed that the risk of implant failure was not influenced by BMI, absolute body weight, or sex. Conversely, an increased failure risk was observed in mobile meniscus prostheses in comparison with those with a fixed meniscus (Rate Ratio 1.88); an increased failure risk was also related to age (Rate Ratio 1.05 per year). These results were also confirmed when considering septic loosening as the end-point. There were no differences in the rate of perioperative complications and death in the 4 classes of BMI. CONCLUSION: In conclusion, cemented knee prostheses, implanted in patients with arthritis do not have significantly different rates of survival or perioperative complications in obese subjects compared with normal weight subjects, at least up to 5 years after surgery. The conclusion also applies to subjects affected by morbid obesity, altough this findings should be regarded with caution due to the small sample examined.
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spelling pubmed-26608962009-03-26 Relationship between obesity and early failure of total knee prostheses Bordini, Barbara Stea, Susanna Cremonini, Sara Viceconti, Marco De Palma, Rossana Toni, Aldo BMC Musculoskelet Disord Research Article BACKGROUND: Obesity is a risk factor for knee arthritis. Total knee arthroplasty is the definitive surgical treatment of this disease. Therefore, a high percentage of subjects treated are overweight. Since 2000 in the Emilia-Romagna Region the Register of Orthopedic Prosthetic Implantology, RIPO, has recorded data of all the primary and revision operations performed on the knee; height and weight of patients at the time of surgery have also been recorded. METHODS: To understand how overweight and obesity affect the outcome of knee arthroplasty, a population of subjects treated with cemented total knee arthroplasty between 2000 and 2005 was studied. 9735 knee prostheses were implanted in 8892 patients; 18.9% of the patients were normal weight, 48.2% were overweight (25 < Body Mass Index <= 30), 31.1% were obese (30 < BMI <= 40), and 1.8% were morbidly obese (BMI > 40). Mean and range of follow-up were respectively 3.1 and 1.5–6 yrs. Implant failure was defined as the exchange of at least one component for whatever reason. RESULTS: In normal weight patients there were 36 failures out of 1840 implants (1.96%), in overweight patients there were 87 out of 4692 (1.85%), in obese 59 out of 3031 (1.94%), and in morbidly obese there were 4 out of 172 (2.3%). The mean time to failure for each class was 1.57, 1.48, 1.60, 1.77 yrs. Cox regression analyses showed that the risk of implant failure was not influenced by BMI, absolute body weight, or sex. Conversely, an increased failure risk was observed in mobile meniscus prostheses in comparison with those with a fixed meniscus (Rate Ratio 1.88); an increased failure risk was also related to age (Rate Ratio 1.05 per year). These results were also confirmed when considering septic loosening as the end-point. There were no differences in the rate of perioperative complications and death in the 4 classes of BMI. CONCLUSION: In conclusion, cemented knee prostheses, implanted in patients with arthritis do not have significantly different rates of survival or perioperative complications in obese subjects compared with normal weight subjects, at least up to 5 years after surgery. The conclusion also applies to subjects affected by morbid obesity, altough this findings should be regarded with caution due to the small sample examined. BioMed Central 2009-03-05 /pmc/articles/PMC2660896/ /pubmed/19265522 http://dx.doi.org/10.1186/1471-2474-10-29 Text en Copyright © 2009 Bordini et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Bordini, Barbara
Stea, Susanna
Cremonini, Sara
Viceconti, Marco
De Palma, Rossana
Toni, Aldo
Relationship between obesity and early failure of total knee prostheses
title Relationship between obesity and early failure of total knee prostheses
title_full Relationship between obesity and early failure of total knee prostheses
title_fullStr Relationship between obesity and early failure of total knee prostheses
title_full_unstemmed Relationship between obesity and early failure of total knee prostheses
title_short Relationship between obesity and early failure of total knee prostheses
title_sort relationship between obesity and early failure of total knee prostheses
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2660896/
https://www.ncbi.nlm.nih.gov/pubmed/19265522
http://dx.doi.org/10.1186/1471-2474-10-29
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