Abstract
Morbidly obese patients undergoing total knee arthroplasty have worse functional outcomes
and implant survival, and increased revision rates compared with nonobese patients.
In addition to increased medical comorbidities and difficult exposure, increased stress
on the tibial implant and altered kinematics of knee motion contribute to aseptic
loosening and medial collapse. Increased implant fixation, including use of a stemmed
tibial implant, may be a way to help avoid these complications. While there is limited
data on tibial stems in the morbidly obese patients specifically, cemented stemmed
tibial implants should be strongly considered in these patients, especially if bone
quality is poor. The initial increased cost of a stemmed implant can be justified
in this high-risk patient population to minimize the risk of costly revisions related
to compromised tibia component fixation.
Keywords
tibial stems - obesity - total knee arthroplasty
