Skip to main content
Key Specialties
Anesthesiology Cardiology Dermatology Diabetology Endocrinology Gastroenterology General Medicine Geriatrics Hematology Infectious Diseases Internal Medicine Nephrology Neurology Obstetrics and Gynecology Oncology Pediatrics Psychiatry Radiology Respiratory Medicine Rheumatology Surgery Urology
Congress Coverage
ASH 2024 Annual Meeting 2024 ESMO Congress 2024 ERS Congress 2024 EASD Congress 2024 ESC Congress 2024 EAN Congress 2024 ASCO Annual Meeting 2024 ACC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote series | Spotlight on menopause

Menopause can have a significant impact on the body, with effects ranging beyond the endocrine and reproductive systems. Learn about the systemic effects of menopause, so you can help patients in your clinics through the transition.

Published: Thursday 12th December 2024
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in:

Open Access 01-12-2024 | Obesity | Research

Does body mass index (BMI) significantly influence aseptic loosening in primary total knee arthroplasty? Insights from a long-term retrospective cohort study

Authors: Mohammad Ayati Firoozabadi, Amir Hossein Mafi, Sina Afzal, Shahabaldin Beheshti Fard, Homayoon Khaledian, Ali Bozorgsavoji, Sina Azadnajafabad, Seyed Mohammad Javad Mortazavi

Published in: BMC Musculoskeletal Disorders | Issue 1/2024

Login to get access

Abstract

Background

Total knee arthroplasty (TKA) offers substantially improved function for patients with severe osteoarthritis, but long-term success can be overshadowed by aseptic loosening, a complication with a multifactorial etiology. This study aims to investigate the association between BMI and the rate of aseptic loosening and other complications in patients undergoing primary TKA.

Methods

This retrospective cohort study examined 354 TKA patients, evenly categorized by BMI (≤ 30 kg/m² and > 30 kg/m²). Demographics, imaging findings, surgical details, and postoperative complications were assessed. Survival for postoperative complications was compared between the two BMI cohorts using Kaplan-Meier analysis.

Results

The mean age of patients in the BMI ≤ 30 group was 62.44 years, while it was 62.84 years in the BMI > 30 group. The number of patients with short-stemmed tibial components was comparable in the two groups. Out of the total patients, 350 cases showed no loosening, while four experienced aseptic loosening. There was no statistically significant difference in the rate of aseptic loosening or other complications between the two groups.

Conclusion

While a high BMI may contribute to aseptic loosening, it does not appear to be the sole determinant. A multifactorial approach to prevention and management is essential, considering patient-specific factors and prosthetic considerations. Future research with larger cohorts and extended follow-up periods is needed to better elucidate the interplay between BMI and aseptic loosening in patients undergoing TKA.
Literature
1.
Jorgensen NB, McAuliffe M, Orschulok T, Lorimer MF, de Steiger R. Major aseptic revision following total knee replacement: a study of 478,081 total knee replacements from the Australian Orthopaedic Association National Joint Replacement Registry. JBJS. 2019;101(4):302–10.CrossRef
2.
Gothesen O, Lygre SHL, Lorimer M, Graves S, Furnes O. Increased risk of aseptic loosening for 43,525 rotating-platform vs. fixed-bearing total knee replacements: a Norwegian–Australian registry study, 2003–2014. Acta Orthop. 2017;88(6):649–56.CrossRefPubMedPubMedCentral
3.
Schiffner E, Latz D, Thelen S, Grassmann JP, Karbowski A, Windolf J, et al. Aseptic loosening after THA and TKA - do gender, tobacco use and BMI have an impact on implant survival time? J Orthop. 2019;16(3):269–72.CrossRefPubMedPubMedCentral
4.
Buller LT, Rao V, Chiu Y-F, Nam D, McLawhorn AS. Primary Total Knee Arthroplasty Performed Using High-Viscosity Cement is Associated with higher odds of revision for aseptic loosening. J Arthroplast. 2020;35(6):S182–9.CrossRef
5.
Organization WH. Global database on Body Mass Index: BMI Classification. 2006. World Health Organization: Geneva, Switzerland. 2015.
6.
Wendelboe AM, Hegmann KT, Biggs JJ, Cox CM, Portmann AJ, Gildea JH, et al. Relationships between body mass indices and surgical replacements of knee and hip joints. Am J Prev Med. 2003;25(4):290–5.CrossRefPubMed
7.
Abdel MP, Bonadurer GF III, Jennings MT, Hanssen AD. Increased aseptic tibial failures in patients with a BMI ≥ 35 and well-aligned total knee arthroplasties. J Arthroplast. 2015;30(12):2181–4.CrossRef
8.
Parratte S, Ollivier M, Lunebourg A, Verdier N, Argenson JN. Do stemmed Tibial Components in total knee arthroplasty improve outcomes in patients with obesity? Clin Orthop Relat Res. 2017;475(1):137–45.CrossRefPubMed
9.
Parratte S, Ollivier M, Lunebourg A, Verdier N, Argenson JN. Do stemmed Tibial Components in total knee arthroplasty improve outcomes in patients with obesity? Clin Orthop Relat Research®. 2017;475(1):137–45.CrossRef
10.
Cherian JJ, Jauregui JJ, Banerjee S, Pierce T, Mont MA. What host factors affect aseptic loosening after THA and TKA? Clin Orthop Relat Research®. 2015;473(8):2700–9.CrossRef
11.
Naziri Q, Issa K, Malkani AL, Bonutti PM, Harwin SF, Mont MA. Bariatric orthopaedics: total knee arthroplasty in super-obese patients (BMI > 50 kg/m2). Survivorship and complications. Clin Orthop Relat Research®. 2013;471(11):3523–30.CrossRef
12.
Durig N, Pace T, Broome B, Osuji O, Harman MK. Clinical outcomes of tibial components with modular stems used in primary TKA. Adv Orthop. 2014;2014.
13.
Scott CEH, Biant LC. The role of the design of tibial components and stems in knee replacement. J Bone Joint Surg Br Volume. 2012;94–B(8):1009–15.CrossRef
14.
Rossi R, Rosso F, Cottino U, Dettoni F, Bonasia DE, Bruzzone M. Total knee arthroplasty in the valgus knee. Int Orthop. 2014;38(2):273–83.CrossRefPubMed
15.
Ho JPY, Merican AM, Ayob KA, Sulaiman S-H, Hashim MS. Tibia vara in asians: myth or fact? Verification with three-dimensional computed tomography. J Orthop Surg. 2021;29(1):2309499021992618.CrossRef
16.
Xie T, Jiao X, Yao X, Li Z, An S, Cao G. How much the leg length has changed after the MOUKA through measurement of the full length radiographs? Beware of splicing error. BMC Musculoskelet Disord. 2023;24(1):343.CrossRefPubMedPubMedCentral
17.
Ewald FC. The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Research®. 1989;248:9–12.
18.
Uivaraseanu B, Vesa CM, Tit DM, Abid A, Maghiar O, Maghiar TA, et al. Therapeutic approaches in the management of knee osteoarthritis (review). Exp Ther Med. 2022;23(5):328.CrossRefPubMedPubMedCentral
19.
Menken LG, Fleuriscar J, Weiner T, Berliner ZP, Rodriguez JA. Aseptic Tibial Implant Loosening after total knee arthroplasty: Preventable? J Am Acad Orthop Surg. 2021;29(8):326–30.PubMed
20.
Stotter C, von Roth P. [Diagnosis of loosening after knee arthroplasty]. Orthopade. 2021;50(12):972–8.CrossRefPubMed
21.
Longawa L, Buller LT, Ziemba-Davis M, Meneghini RM. Incidence and Causes of Tibial Component Loosening Based on Level of Obesity in a Large Consecutive Cohort of Cemented Primary TKAs without Stem Extensions. Proceedings of IMPRS. 2020;3(1).
22.
Nicholls A, Kiran A, Javaid MK, Hart D, Spector T, Carr A, Arden N. Change in body mass index during middle age affects risk of total knee arthoplasty due to osteoarthritis: a 19-year prospective study of 1003 women. Knee. 2012;19(4):316–9.CrossRefPubMedPubMedCentral
23.
Elcock KL, MacDonald DJ, Clement ND, Scott CEH. Total knee arthroplasty in patients with severe obesity: outcomes of standard keeled tibial components versus stemmed universal base plates. Knee Surg Relat Res. 2023;35(1):9.CrossRefPubMedPubMedCentral
Metadata
Title
Does body mass index (BMI) significantly influence aseptic loosening in primary total knee arthroplasty? Insights from a long-term retrospective cohort study
Authors
Mohammad Ayati Firoozabadi
Amir Hossein Mafi
Sina Afzal
Shahabaldin Beheshti Fard
Homayoon Khaledian
Ali Bozorgsavoji
Sina Azadnajafabad
Seyed Mohammad Javad Mortazavi
Publication date
01-12-2024
Publisher
BioMed Central
Keywords
Obesity
Obesity
Published in
BMC Musculoskeletal Disorders / Issue 1/2024
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-024-07913-0

Other articles of this Issue 1/2024

Metal interference screw fixation combinations show high revision rates in primary hamstring tendon ACL reconstruction

  • Open Access
  • Research

Opportunistic hand radiographs to screen for low forearm bone mineral density: a prospective and retrospective cohort study

The association of the STarT Back Screening Tool and type of leg pain with low back pain disability trajectories: a prospective cohort study

Trends and projection of forearm fractures including elbow fractures of the Olecranon in Sweden: an analysis of 363 968 fractures using public aggregated data

A modified anatomical posterior cruciate ligament reconstruction technique using the posterior septum and posterior capsule as landmarks to position the low tibial tunnel

3D-printed orthoses and prostheses for people with physical disability in rehabilitation centers: a scoping review

  • Open Access
  • Orthosis
  • Systematic Review