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All-Polyethylene Tibial Components in Obese Patients Are Associated With Low Failure at Midterm Followup

  • Symposium: Papers Presented at the Annual Meetings of The Knee Society
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

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 TKA components, which may lead to increased polyethylene wear, osteolysis, radiolucencies, and clinical failure. Metal-backed 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 all-polyethylene 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, all-polyethylene 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.

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Acknowledgment

The authors thank Mary Jo Adams, RN, for her invaluable assistance in this study.

Author information

Authors and Affiliations

  1. Towson Orthopaedic Associates, LLC, Towson, MD, USA

    David F. Dalury MD

  2. c/o Elaine P. Henze, BJ, ELS, Medical Editor and Director, Editorial Services, Department of Orthopaedic Surgery, Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, #A665, Baltimore, MD, 21224-2780, USA

    David F. Dalury MD

  3. Oro Valley Hospital, Oro Valley, AZ, USA

    Kimberly K. Tucker MD

  4. Department of Orthopaedic Surgery, University of Cincinnati, Cincinnati, OH, USA

    Todd C. Kelley MD

Authors
  1. David F. Dalury MD
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  2. Kimberly K. Tucker MD
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  3. Todd C. Kelley MD
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Corresponding author

Correspondence to David F. Dalury MD.

Additional information

One of the authors (DFD) has received research funding from DePuy Orthopaedics Inc (Warsaw, IN) that was not related to this work and that author’s institution has received funding from DePuy. The authors have no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution approved or waived approval for the reporting of these cases and that all investigations were conducted in conformity with ethical principles of research.

This work was performed at Towson Orthopaedic Associates.

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Dalury, D.F., Tucker, K.K. & Kelley, T.C. All-Polyethylene Tibial Components in Obese Patients Are Associated With Low Failure at Midterm Followup. Clin Orthop Relat Res 470, 117–124 (2012). https://doi.org/10.1007/s11999-011-1964-1

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  • DOI: https://doi.org/10.1007/s11999-011-1964-1

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