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2016 ; 98
(5
): 295-9
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Hip and knee arthroplasty implants contraindicated in obesity
#MMPMID27023636
Craik JD
; Bircher MD
; Rickman M
Ann R Coll Surg Engl
2016[May]; 98
(5
): 295-9
PMID27023636
show ga
INTRODUCTION: High patient weight is a risk factor for mechanical implant failure
and some manufacturers list obesity as a contraindication for implant use. We
reviewed data from the 2012-2013 UK National Joint Registry to determine whether
surgical practice reflects these manufacturer recommendations. METHODS: The
product literature for the most commonly used hip and knee implants was reviewed
for recommendations against use in obese patients (body mass index [BMI] ?
30kg/m(2)). The total number of obese patients undergoing hip and knee
arthroplasty was calculated, as was the proportion receiving implants against
manufacturer recommendations. RESULTS: Out of 200,054 patient records, 147,691
(74%) had a recorded BMI. The mean BMI for patients undergoing primary total hip
arthroplasty was 29kg/m(2), compared with 31kg/m(2) for total knee arthroplasty.
Of the 25 components reviewed, 5 listed obesity as a contraindication or
recommended against implant use in obese patients. A total of 10,745 patients
(16% of all obese patients) received implants against manufacturer
recommendations. CONCLUSIONS: A high proportion of patients are receiving
implants against manufacturer recommendations. However, there are limitations to
using BMI for stratifying risk of implant fatigue failure and manufacturers
should therefore provide more detailed guidelines on size specific implant load
limits to facilitate surgical decisions.
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