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Cemented vs Cementless Total Knee Arthroplasty in Morbidly Obese Patients
Deren T Bagsby1, Kimona Issa2, Langan S Smith3
1Department of Orthopedics, Indiana University School of Medicine, Indianapolis, Indiana.
Background:
Primary total knee arthroplasty (TKA) in morbidly obese patients has been associated with greater postoperative complications. Cementless TKA has the potential for biologic fixation which may provide more durable long-term stability.
Methods:
This was a multicenter review of 298 TKAs in 292 morbidly obese patients (body mass index, >40) undergoing TKA, with 154 TKAs (149 patients) in the cemented and 144 TKAs (143 patients) in the cementless group.
Results:
There were significantly more revisions in the cemented group (n = 20) than in the cementless group (n = 1; 13.0% vs 0.7%). There was a significantly higher incidence of aseptic loosening in the cemented cohort vs the cementless cohort (9 vs 0 TKAs). All revisions in the cementless cohort were due to infection (0.7%).
Conclusion:
Cementless fixation may be an alternative in the morbidly obese patient undergoing primary TKA.
