Obesity and Perioperative Morbidity after Total Hip Arthroplasty in Osteoarthritis Patients

PURPOSE: To evaluate the effect of obesity on perioperative morbidity following total hip arthroplasty in patients with severe osteoarthritis. MATERIALS AND METHODS: Between April 1987 and April 2007, 272 patients with severe osteoarthritis underwent total hip arthroplasty. One hundred seventeen patients were obese (body mass index, BMI> or =25 kg/m2), and 155 were not obese (BMI0.05). However, the medical complication rate was significantly higher in the obese group compared to the non-obese group (4.3% vs. 0.6%, p or =25 kg/m2) has no observable effect on perioperative morbidity in terms of length of hospital stay, operation time, total blood loss and replacement, or surgical complication rate, but is associated with a higher medical complication rate.

Cementless Total Knee Arthroplasty with Posterior Cruciate Retention in Rheumatoid Arthritis

PURPOSE: The result of cementless total knee arthroplasty with posterior cruciate ligament retention in rheumatoid arthritis patients was evaluated. MATERIALS AND METHODS: Thirty patients (fifty knees) followed up after cementless total knee arthroplasty with posterior cruciate ligament retention was evaluated clinically and radiologically. Average follow up was 9.2 years(5.1~14.3). RESULTS: The mean HSS knee score improved from 47.4 preoperatively to 81.8 postoperatively, and the mean range of motion of 89.7 degrees preoperatively to 101.2 degrees postoperatively. The mean tibiofemoral angle was 4.9 degrees valgus. Posterior instability was observed in 1 case(2%) at the most recent follow up. Radiolucent line was observed in 41 cases(82%), and osteolysis was observed around tibial component in 13 cases(26%), and around femoral component in 4 cases(8%). Eight cases(16%) of revision was due to 1 case of aseptic loosening and osteolysis each, and the other due to polyethylene wear of patellar or tibial component. CONCLUSION: Although there are osteopenia in rheumatoid arthritis compared to osteoarthritis, cementless total knee replacement with posterior cruciate retention showed stable fixation. However, the new method for initial fixation of tibial component is needed because osteolysis around tibial component tended to start around cancellous screws.