Cemented, cementless TKA yield similar outcomes in patients with obesity
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For patients with obesity, cemented and cementless total knee arthroplasty yielded similar clinical outcomes and implant survivorship at 6 months and 2 years, according to published results.
Graham S. Goh, MD, and colleagues from Rothman Orthopaedic Institute at Thomas Jefferson University analyzed 406 patients with a BMI of at least 35 kg/m2 who underwent primary cementless TKA and a matched cohort of 406 patients who underwent cemented TKA from 2013 to 2018. Outcome measures included Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR), short form-12 (SF-12) and implant survivorship.
According to the study, both cohorts had similar outcome scores and improvements at 2 years. The cemented cohort had a KOOS-JR of 32.5 and an SF-12 of 13.1, while the cementless cohort had a KOOS-JR of 32.5 and an SF-12 of 11.7 at 2 years. Among the cemented cohort, 70% of patients achieved minimal clinically important difference (MCID) in KOOS-JR, while 74.1% achieved MCID in SF-12. Similarly, 71.2% of patients in the cementless cohort achieved MCID in KOOS-JR, while 70.4% achieved MCID in SF-12. Goh and colleagues also noted both cohorts had at least 99% survivorship free from aseptic revision at 7 years.
“The influence of obesity on the outcomes of TKA is well documented, and a higher BMI has been linked to an increased risk of aseptic loosening due to greater stress across the components and increased load on the surrounding bone,” Goh and colleagues wrote in the study. “Despite these encouraging results of cementless TKA in highly obese patients, continued surveillance of this high-risk patient cohort is necessary.”
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