Total knee arthroplasty (TKA) for obese patient entails more preoperative comorbidities and complications, and shorter longevity. This article is a retrospective review comparing longevity of the constrained implant with a standard prosthesis. Patient-specific data, Knee Society Scores, complications, and revisions were recorded and compared. No statistical differences were found. The constrained condylar knee for obese patients improves the intramedullary alignment of the prosthesis and supports the surrounding soft tissues. The clinical results are similar to a standard implant in the nonobese with similar longevity at midterm follow-up.
The constrained condylar knee for obese patients facilitates the operative procedure by improving the intramedullary alignment of the prosthesis and supporting the surrounding soft tissues. The clinical results are similar to standard implants in the nonobese with similar longevity at midterm follow-up.
The constrained condylar knee for obese patients facilitates the operative procedure by improving the intramedullary alignment of the prosthesis and supporting the surrounding soft tissues. The clinical results are similar to standard implants in the nonobese with similar longevity at midterm follow-up.
Table 1 summarizes the results. There were 3 reoperations in the obese group: 1 prosthetic loosening, 1 incision and drainage for a superficial infection, and 1 proximal realignment for a dislocating patella without component malalignment. There was 1 revision for loosening in the control group and 1 manipulation for decreased range of motion.
| Obese | Nonobese | P Value<.05 Significant | |
|---|---|---|---|
| BMI | 40.7 (Range 31–55) | 26.4 (Range 22–30) | <0.001 |
| Average Age | 59 y (Range 45–70) | 65 y (Range 45–75) | <0.001 |
| Comorbidities | 2.3 | 0.9 | <0.001 |
| Preoperative ROM | 113° | 117° | <0.001 |
| Change in ROM | +6.1° | +2.4° | 0.013 |
| Surgical Time | 96.min | 79.min | 0.015 |
| Knee Society Preoperative Pain | 39 | 43 | 0.004 |
| Knee Society Postoperative Pain | 96 | 96 | — |
| Change in Knee Society Pain | 57 | 53 | 0.005 |
| Knee Society Preoperative Function | 33 | 39 | <0.001 |
| Knee Society Postoperative Function | 79 | 83 | 0.03 |
| Change in Knee Society Function | 46 | 44 | 0.49 |
| Average Length of Follow-up | 6.9 y | 6.1 y | 0.02 |
| Complications | 8 | 8 | — |
| Reoperations | 3 | 2 | — |
| Average Preoperative Radiograph Varus | 6.3° | 5.6° | 0.15 |
| Average Preoperative Radiograph Valgus | 11.2° | 8.3° | <0.001 |
| Average Postoperative Valgus Alignment | All 3°–7° | All 3°–7° | — |
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