Background: We investigated if the use of augmented tibial fixation with stems in primary total knee arthroplasty (TKA) in obese patients was associated with a difference in reason for revision, type of revision, or overall revision rate.
Methods: Data from the Australian Orthopaedic Association National Joint Replacement Registry compared reason for revision, rate, and type of revision between primary TKA using stemmed tibial prostheses to nonstemmed prostheses, stratified by body mass index (BMI) and obesity. The cumulative percent revision was obtained using the Kaplan-Meier method, and Cox proportional hazards models estimated hazard ratios (HRs) adjusted for age and sex with 95% confidence intervals (CIs). All tests were 2-tailed at 5% statistical significance (P < .05). There were 66,508 procedures available for analyses.
Results: Obese class 2 (BMI 35 to 39.99) had higher rates of revision in the stemmed group compared to the nonstemmed group (HR 1.44, 95% CI 1.00, 2.05, P = .047). There was no significant difference in revision rates between stemmed and nonstemmed tibial prostheses in any other BMI group. Primary TKA in obese patients (BMI ≥30) with a stem extension had a significantly higher rate of minor revisions compared to no stem extension (HR 1.31, 95% CI 1.03, 1.66, P = .025). There was no significant difference between stemmed and nonstemmed groups for major revision in obese patients and for minor or major revision in nonobese patients.
Conclusion: Using a tibial stem during primary TKA in obese patients is not associated with a lower rate of revision.
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http://dx.doi.org/10.1016/j.arth.2023.08.028 | DOI Listing |
Endocr Metab Immune Disord Drug Targets
January 2025
Pharmacy Department, Tishk International University, Erbil, Kurdistan Region, Iraq.
Sedentary lifestyles and prolonged physical inactivity are often linked to poor mental and physical health as well as an increased risk of a number of chronic illnesses, including cancer, obesity, type 2 diabetes, and cardiovascular problems. Metabolic Syndrome (MetS), as the new disease, has emerged as the world's leading cause of illness. Despite having its roots in the West, this issue has now completely globalized due to the development of the Western way of life throughout the world.
View Article and Find Full Text PDFActa Med Philipp
December 2024
Division of Pediatric Pulmonology, Department of Pediatrics, College of Medicine and Philippine General Hospital, University of the Philippines Manila.
Objective: Our study aimed to identify and describe pulmonary complications and its associated risk factors in children with suspected or confirmed obstructive sleep apnea (OSA) who underwent tonsillectomy or adenotonsillectomy in a tertiary government hospital.
Methods: We conducted a retrospective cohort study. Medical charts of pediatric patients with suspected or confirmed OSA who were admitted for tonsillectomy or adenotonsillectomy from January 1, 2016 to December 31, 2020 were retrieved and reviewed.
J Spine Surg
December 2024
Department of Neurosurgery, General Hospital Bamberg, Bamberg, Germany.
Background: Surgical treatment of therapy-resistant radiculopathy associated with lumbar herniated discs in patients with extreme obesity is a challenge for neurosurgeons. In addition to technical problems in surgery due to the abundant subcutaneous adipose tissue and perioperative risks, there are significant anesthetic risks when anesthesia is performed with a patient in the prone position. A surgical procedure should preferably be minimally traumatic and quick with minimal risks of complications.
View Article and Find Full Text PDFJ Clin Orthop Trauma
February 2025
University of Edinburgh, Edinburgh, United Kingdom.
Background: Scotland has one of the highest rates of obesity in the developed world which increases risk of lower limb osteoarthritis resulting in total joint arthroplasty (TJA). This paper aimed to investigate (1) current practice of orthopaedic consultants in Scotland in managing end-stage hip and knee osteoarthritis in obese patients, (2) adherence to National guidelines, and (3) understanding of complication risks in lower limb TJA for BMI≥40.
Methods: A 15-question online survey was sent to all active members of Scottish Committee for Orthopaedics and Trauma (SCOT) between February and March 2023 to understand the current practices for managing obese patients with lower limb arthritis requiring joint replacement surgery.
IBRO Neurosci Rep
June 2025
Université de la Réunion, INSERM, UMR 1188 Diabète Athérothrombose Thérapies Réunion Océan Indien (DéTROI), Saint-Pierre 97410, France.
It is well recognized that type II Diabetes (T2D) and overweight/obesity are established risk factors for stroke, worsening also their consequences. However, the underlying mechanisms by which these disorders aggravate outcomes are not yet clear limiting the therapeutic opportunities. To fill this gap, we characterized, for the first time, the effects of T2D and obesity on the brain repair mechanisms occurring 7 days after stroke, notably glial scarring.
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