A comparative prospective study between stemmed versus an unstemmed tibial component in total knee arthroplasty in obese
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ORIGINAL ARTICLE
A comparative prospective study between stemmed versus an unstemmed tibial component in total knee arthroplasty in obese patients Mohamed Mansour Elzohairy1 · Sherif Mohamed Elaidy1 · Mohamed Elsadek Attia1 Received: 7 June 2020 / Accepted: 15 October 2020 © Springer-Verlag France SAS, part of Springer Nature 2020
Abstract Background There is no consensus in the literature regarding the patients with obesity who do well with TKA, or this group is at risk of a variety of complications. Implant choices between the two types of implants which either long or standard stem can improve the likelihood that a patient with obesity will achieve high scores for function and quality of life after TKA. Methods This prospective clinical study included 200 patients who were categorized into two groups: group (1) traditional (standard) unstemmed cemented tibial tray (n = 100 patients) and group (2) stemmed cemented tibial tray with the cementless press-fit stem (n = 100 patients). Results The average follow-up was (7.6 ± 1 years) (range from 6.5 up to 10 years). The average age of the stemmed group was 55.69 ± 8.45 and for the unstemmed group was 57.3 ± 7.8. The average BMI for the stemmed patients was 38.84 ± 3.89, while for the standard (unstemmed) group was 40.0 ± 3.95. Functional results showed significant improvement in both groups but more in the stemmed group (LS) as the difference and change between pre and post were more significant at long stem (P > 0.001). Conclusion Based on our results, there were significant improvements in both groups either stemmed or unstemmed TKA but more in the stemmed group which had higher functional outcomes compared to the unstemmed group. Level of evidence IV. Keywords Stemmed · Versus · Unstemmed · Tibial component · Total knee arthroplasty · Obese patients
Introduction Over the last three decades, the incidence of obesity has progressively increased worldwide [1–3]. Simultaneously, the incidence of primary and revision total knee replacement has dramatically increased over the last years with an * Mohamed Mansour Elzohairy [email protected] http://www.mmmansour.faculty.zu.edu.eg https://scholar.google.com.eg/citations? user=XfVQ6RsAAAAJ&hl=en https://www.researchgate.net/profile/Mohamed_Elzohairy Sherif Mohamed Elaidy [email protected] Mohamed Elsadek Attia [email protected] 1
Faculty of Medicine, Zagazig University, Zagazig city 4451, Ash Sharqia Governorate, Egypt
expected further increase for knee arthroplasty operations in the upcoming years [4]. TKA in morbidly obese patients is a difficult procedure because of many patient comorbidities and anatomical factors and also the long-term outcomes in morbidly obese patient group are still unclear. A survey study by the Global Health Observatory (2014) reported that 13% of the world population is considered obese [5]. Every year about 3 million people die worldwide from complications of obesity. In 2017, the WHO statistics found that 35% of Egyptian adults (more than 35 mill
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