CALL NOW FOR AN APPOINTMENT 425.656.5060

Online Appointment Requests

For convenient scheduling, request an appointment online.

Complications Related to Obesity in Total Knee Replacements

By William P. Barrett, MD on

In an article published in the May 2017 edition of Journal of Arthroplasty, authors Fehring, et al, describe their experience with total knee tibial component loosening in obese individuals. What they found is that patients with a BMI greater than 35 placed increased strain on the bone in the proximal or top part of the shin bone (tibia). Due to the fact that the majority of these patients were female with an elevated BMI, the bone size does not match the weight of the patient. Therefore, the amount of stress placed on the bone exceeds the strength of the bone. This led to catastrophic loosening of the implant and need for revision. This is a situation that has been recognized over the last several years and led orthopedic surgeons to use longer stems on the implant that is placed in the shin bone. This is thought to be advantageous in individuals with elevated weight and smaller bone size to help offload the stress at the top of the bone.

The authors point out that these findings of increased failure rate in individuals with elevated weight and smaller bones sheds light on the need to optimize patients before surgery to get their weight to a more acceptable level, and, if this is not possible, using longer stemmed implants to try and dissipate the loads placed on the top part of the bone.

This is yet another example of the need to optimize patients physical and mental health prior to joint replacement surgery, and to also alter our surgical technique to try and accommodate some of these challenges.

Dr. Barrett is an orthopedic surgeon who performs over 500 joint replacement surgeries annually. For more information about total hip and knee replacements, contact Proliance Orthopedic Associates at 425.656.5060.

LOCATIONS

RENTON

4011 Talbot Rd S #300
Renton, WA 98055

Phone: 425.656.5060
Fax: 425.656.5047

COVINGTON

27005 168th Pl SE #201
Covington, WA 98042

Phone: 253.630.3660
Fax: 253.631.1591

Maple Valley

24060 SE Kent Kangley Rd,
Maple Valley, WA 98038

Phone: 425.358.7708
Fax: 425.656.5047

Latest POA News

  • To Walk or to Run?

    There’s no debate that walking and running are both excellent forms of exercise with plenty of benefits, from enhancing heart health to promoting stronger bones. So, when it comes to cardio, which should you choose – to walk or to run? Arguments can be made for both, so it’s worth considering your goals and the …

  • Eat These Foods to Speed Up Recovery After Surgery

    Recovery speed and effectiveness after orthopedic surgery are largely determined by what we eat. Not only does our body need more calories to recover, but surgery also causes a stress reaction in the body that elevates the metabolism and increases our need for calories. If we don’t fuel our recovery with the proper foods, complications …

  • Sweat Safely This Summer

    Summer is here, which means outdoor activity and summer sports injuries are too. While POA is here to provide you with orthopedic care, we prefer you don’t get hurt in the first place. Whether you’re swimming laps, hiking mountains, or spiking volleyballs, here are some tips on staying safe this season: Gear Up and Warm …

Dr. Barrett's Blog

  • Managing Joint Replacement Post-Op Opioid Use

    An article published in JBJS Feb. 2018 by Sabatino et al documented excess opioid prescribing for patients undergoing THA/TKA procedures. They noted that post-op pain management for several major orthopedic procedures accounts for a substantial portion of opioid medications prescribed in the US. The authors evaluated the prescribing habits and patient utilization following elective orthopedic procedures at …

  • The Importance of Physician Assistants

    There are over 1 million hip and knee replacements performed in the U.S. per year and this number is expected to increase significantly over the next decade. There is a finite number of orthopedic surgeons trained to perform this kind of surgery, and that number is not increasing at a rate to keep up with …

  • Managing Your Pain After Joint Replacement Surgery

    At POA, we use multimodal pain management for your joint replacement. This begins with preoperative medications given in the pre-op area, spinal anesthesia, and use of regional and local blocks about your hip or knee. Following your surgery pain is managed during your overnight stay by the nursing staff at the VMC joint center. This consists …