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The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...
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Related Experiment Video

Updated: Jun 19, 2026

In Vivo Quantification of Hip Arthrokinematics during Dynamic Weight-bearing Activities using Dual Fluoroscopy
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[Current AWMF guidelines on knee and hip arthroplasty - individual risks].

Dimitrios Mouselimis1, Christian Lüring2

  • 1Lehrstuhl für Orthopädie, Klinikum Dortmund, Universität Witten-Herdecke, Beurhausstraße 40, 44137, Dortmund, Deutschland.

Orthopadie (Heidelberg, Germany)
|February 4, 2025
PubMed
Summary

Managing modifiable risk factors like obesity is key to reducing complications after total hip and knee arthroplasty. Guidelines recommend weight loss for patients with a BMI over 30, with careful individual assessment for those with higher BMIs.

Keywords:
Body mass indexDiabetes mellitusJoint replacementObesityPostoperative complications

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Area of Science:

  • Orthopedic Surgery
  • Public Health
  • Medical Guidelines

Context:

  • Over 300,000 primary hip and knee arthroplasties were performed in Germany in 2022.
  • Increasing surgical numbers correlate with a rise in potential postoperative complications.
  • International data aids in identifying risk factors for these complications.

Purpose:

  • To highlight the importance of managing modifiable risk factors in arthroplasty surgery.
  • To emphasize the focus of German orthopedic professional societies on factors like obesity, diabetes mellitus, and smoking.
  • To review current guidelines regarding obesity and arthroplasty.

Summary:

  • German guidelines recommend weight loss for patients with a Body Mass Index (BMI) > 30 kg/m² prior to knee and hip arthroplasty.
  • A BMI ≥ 40 kg/m² is considered a relative contraindication, necessitating careful risk-benefit assessment.
  • Shared decision-making is crucial for obese patients undergoing arthroplasty.

Impact:

  • Effective management of modifiable risk factors can decrease the incidence of postoperative complications.
  • This approach supports patient safety and optimizes outcomes in joint replacement surgery.
  • Promoting weight loss and informed decision-making can improve the success rate of arthroplasty procedures.