Cemented Knee Replacement Devices Fail at a Higher Rate in Obese Patients
Obesity not osteoarthritis should be considered more carefully before a doctor recommends total knee replacement
Tuesday, July 2, 2019 - A stunning article published earlier in 2019 by a leading orthopedic authority reveals the results of a scientific study that points to obesity as the cause of a large percentage of total knee revision failures that require immediate revision surgery. According to the study published in the Orthopedics This Week, Dr. Arthur Malkani, M.D. of the University of Louisville Adult Reconstruction Program studied the relative failure rates of knee replacement devices that use cemented vs, non-cemented techniques on patients that were morbidly obese. Dr. Malkani concluded: "We were seeing higher failure rates following primary cemented TKA in our morbidly obese patients and young active males due to aseptic loosening despite well-aligned knees." The study defined the term obese as someone with a body mass index (BMI) greater than 45.6. To make a long story short, the study concluded that the failure rate of cemented total knee replacements requiring revision surgery to be an incredible 22% whereas 95% of all cementless total knee replacement systems were still intact and working without complaint. National DePuy knee attorneys handling serious injury and death claims across the country offer a free consulation and no obligation.
Companies that manufacturer total knee replacement devices have been scrambling to come up with a solution to the debonding issue. Debonding is the failure of the cement that attaches the artificial knee device to the bones, the tibia at the bottom and femur at the top. When the cement fails and if often does, it is as if the lower leg is no longer attached to the upper and can twist and turn at will. Rather than step straight, the debonding victim could set his/her foot down at a 45-degree angle or more, twisting, turning, stretching and tearing the muscles, tendons, and ligaments that remain to hold the knee in place. When debonding occurs the total knee replacement patient can have a catastrophic fall down a flight of stairs or off of a city curb into traffic. Knee replacement companies are on the verge of a breakthrough in developing a "cementless" artificial knee to eliminate this problem. Some studies are complete and indicate that in younger healthy individuals with osteoarthritis but not overweight, both cemented and cemented knee replacement devices have held their bonds. In fact, obesity or the degree to which an individual is overweight may be the determinate factor in whether or not knee replacement works.
The medical advice website HealthLine.com has summarized the thinking of orthopedic surgeons and other physicians on how important a person's weight is to knee pain. "Knee pain is one of the most common complications of being overweight or obese. If you're among the millions of people who experience chronic knee pain, even a small weight loss can help reduce pain and lower the risk of osteoarthritis (OA). ... Those extra pounds increase the stress on your knees." Statements like this make me wonder how many people are misdiagnosed with osteoarthritis to justify knee replacement surgery when all the patient needs to do to alleviate knee pain is to lose a little weight.
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