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Updated: Feb 6, 2026
Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
Prophylactic Tibial Stem Fixation in the Obese: Comparative Early Results in Primary Total Knee Arthroplasty
Joshua T Steere1, Michael C Sobieraj1, Christopher J DeFrancesco2
1Department of Orthopedic Surgery, Pennsylvania Hospital, University of Pennsylvania Health System, Philadelphia, PA, USA.
Purpose:
Obesity is a risk factor for aseptic loosening after total knee arthroplasty (TKA). Prophylactic use of tibial stems may enhance tibial fixation in obese patients. The aim of this study was to determine whether a tibial stem extension decreases rates of early failure in obese patients.
Materials And Methods:
This study included 178 consecutive primary TKAs (143 patients) with a body mass index ≥35 kg/m2. Fifty TKAs were performed with the use of a 30 mm tibial stem extension, and 128 TKAs were performed with a standard tibial component. Patients with two-year clinical follow-up were included. The primary outcome was revision for aseptic loosening. Secondary outcomes were all-cause revision and radiolucent lines (RLLs) on radiographs.
Results:
Average follow-up was 34 months (range, 24 to 46 months). No failures for aseptic loosening occurred. The occurrence of secondary procedures was not significantly different between groups. Quantification of RLLs revealed no difference between groups.
Conclusions:
At early follow-up, no difference was measured in revision rates, need for subsequent procedures, or RLLs between groups.
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