Better Outcomes in Severe and Morbid Obese Patients<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:mo>(</mml:mo><mml:mrow><mml:mtext>BMI</mml:mtext><mml:mo>&gt;</mml:mo><mml:mn mathvariant="bold">35</mml:mn><mml:mo> </mml:mo><mml:mtext>kg</mml:mtext><mml:mo>/</mml:mo><mml:msup><mml:mrow><mml:mtext>m</mml:mtext></mml:mrow><mml:mrow><mml:mn mathvariant="bold">2</mml:mn></mml:mrow></mml:msup></mml:mrow><mml:mo>)</mml:mo></mml:mrow></mml:math>in Primary Endo-Model Rotating-Hinge Total Knee Arthroplasty

Abstract

The Endo-Model rotating-hinge prosthesis is preferably indicated as a primary implant in patients with advanced axial deviation of the lower limbs or unstable knees with severe bone defects. Outcomes were studied in 111 knees, operated in a three-year period; the mean followup was 28 months. Joint balance enhancement and limbs mechanical axis correction were achieved after surgery. There were 6 deep infections and 16 patients referred postoperative anterior knee pain. WOMAC index scores disaggregated by gender and BMI showed better outcomes in obese patients (specifically, those with a BMI of 35-40 kg/m(2)) and in men. Although the lack of a control group did not allow definite conclusions and despite a nonnegligible complication rate, our results reveal that the Endo-Model total knee arthroplasty can be a useful tool to deal with severe and morbid obese patients affected of severe gonarthrosis associated with marked axial deviations, ligament instability, or bone defects.