title: Better outcomes in severe and morbid obese patients (BMI > 35 kg/m2) in primary Endo-Model rotating-hinge total knee arthroplasty.
abstract: The Endo-Model rotating-hinge prosthesis is preferably indicated as a primary implant in patients with advanced axial deviation of the lower limbs or unstable knees with severe bone defects. Outcomes were studied in 111 knees, operated in a three-year period; the mean followup was 28 months. Joint balance enhancement and limbs mechanical axis correction were achieved after surgery. There were 6 deep infections and 16 patients referred postoperative anterior knee pain. WOMAC index scores disaggregated by gender and BMI showed better outcomes in obese patients (specifically, those with a BMI of 35-40 kg/m(2)) and in men. Although the lack of a control group did not allow definite conclusions and despite a nonnegligible complication rate, our results reveal that the Endo-Model total knee arthroplasty can be a useful tool to deal with severe and morbid obese patients affected of severe gonarthrosis associated with marked axial deviations, ligament instability, or bone defects.
authors.affiliation: Knee Surgery Unit, Orthopaedic Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain. skytrauma@hotmail.com
authors.forename: Luis M
authors.initials: LM
authors.lastname: Lozano
authors.forename: Vicente
authors.initials: V
authors.lastname: López
authors.forename: José
authors.initials: J
authors.lastname: Ríos
authors.forename: Dragos
authors.initials: D
authors.lastname: Popescu
authors.forename: Pere
authors.initials: P
authors.lastname: Torner
authors.forename: Félix
authors.initials: F
authors.lastname: Castillo
authors.forename: Francisco
authors.initials: F
authors.lastname: Maculé
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects; D015992:Body Mass Index; D060906:Coxa Valga / Q000150:complications / Q000601:surgery; D060905:Coxa Vara / Q000150:complications / Q000601:surgery; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000209:etiology* / Q000601:surgery; D007719:Knee Joint / Q000601:surgery; D008297:Male; D009767:Obesity, Morbid / Q000150:complications*; D010149:Postoperative Pain; D011474:Prosthesis Design; D016059:Range of Motion, Articular