title: [Morbid obesity in total knee arthroplasty: a critical case review].
abstract: METHODS
  In a 66-year-old obese woman (WHO stage III, BMI 51 kg/m2) pronounced osteoarthritis of the right knee was diagnosed. Because of progressive chronic pain of the right knee joint her walking distance was limited to a few meters. Conservative therapy was exhausted.
  
  
  METHODS
  Clinical examination showed a restricted and painful range of motion of the right knee and distinctive obeseness on the trunk and the extremities including a lipedema/lymphedema.
  
  
  METHODS
  After a complicated course of treatment lasting for 220 days the total knee replacement ended in an arthrodesis combined with a gastrocnemius muscle flap.
  
  
  CONCLUSIONS
  With respect to this case the high complication-rates in obese patients should be taken into account: Total knee replacement can even lead to loss of the limb in the worst case. In addition to extended preoperative examination this indication should be critically scrutinized.
authors.affiliation: Department für Orthopädie, Unfall- und Wiederherstellungschirurgie, Universitätsklinikum Halle/Saale.
authors.forename: V
authors.initials: V
authors.lastname: Brinkmann
authors.affiliation: Department für Orthopädie, Unfall- und Wiederherstellungschirurgie, Universitätsklinikum Halle/Saale.
authors.forename: D
authors.initials: D
authors.lastname: Wohlrab
authors.affiliation: Department für Orthopädie, Unfall- und Wiederherstellungschirurgie, Universitätsklinikum Halle/Saale.
authors.forename: E
authors.initials: E
authors.lastname: Esmer
authors.affiliation: Orthopädisch-Traumatologisches Zentrum Park-Krankenhaus Leipzig, Leipzig.
authors.forename: F
authors.initials: F
authors.lastname: Juch
authors.affiliation: Department für Orthopädie, Unfall- und Wiederherstellungschirurgie, Universitätsklinikum Halle/Saale.
authors.forename: K S
authors.initials: KS
authors.lastname: Delank
authors.affiliation: Department für Orthopädie, Unfall- und Wiederherstellungschirurgie, Universitätsklinikum Halle/Saale.
authors.forename: S
authors.initials: S
authors.lastname: Freche
mesh_terms: D000368:Aged; D001174:Arthrodesis / Q000379:methods*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D005260:Female; D006801:Humans; D009767:Obesity, Morbid / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D020370:Osteoarthritis, Knee / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D011859:Radiography; D016896:Treatment Outcome