ArticleAnnals of the Royal College of Surgeons of England2016
Hip and knee arthroplasty implants contraindicated in obesity.
Article in Annals of the Royal College of Surgeons of England, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- [Perioperative management of obese patients undergoing elective hip and knee arthroplasty].Orthopadie (Heidelberg, Germany) · 2025Pooled it
- Is There a Body Mass Index Threshold for Patients Undergoing Primary Total Knee Replacement-A Literature Review.Journal of clinical medicine · 2025Review
- A survey of Scottish Committee for Orthopaedics and Trauma members on lower limb joint replacement practices in morbidly obese patients.Journal of clinical orthopaedics and trauma · 2025Article
- Justification of Body Mass Index cutoffs for hip and knee joint arthroplasty among California orthopedic surgeons.Journal of orthopaedic surgery and research · 2025Article
- Navigated instrumentation and ligament tensioning device enhances initial gap acquisition during total knee arthroplasty procedure: A cadaveric study.Journal of experimental orthopaedics · 2025Article
- Second opinion and time to knee arthroplasty: a prospective cohort study of 142 patients.BMJ open · 2023Article
- The effect of weight compared to BMI on patient reported outcomes at long term follow up of primary total hip arthroplasty.Journal of orthopaedics · 2023Article
- Deformation of the Titanium Plate Stabilizing the Lateral Ankle Fracture Due to Its Overloading in Case of the Young, Obese Patient: Case Report Including the Biomechanical Analysis.Diagnostics (Basel, Switzerland) · 2022Article
- Clinical Outcome of Primary Total Hip Arthroplasty in Patients with Morbid Obesity-Retrospective and Prospective Follow-Up Studies.Medicina (Kaunas, Lithuania) · 2021Article
- EFORT recommendations for off-label use, mix & match and mismatch in hip and knee arthroplasty.EFORT open reviews · 2021Review
- Total Hip Arthroplasty in the Obese Patient: Tips and Tricks and Review of the Literature.Indian journal of orthopaedics · 2020Review
- Postoperative complications in underweight patients undergoing total hip arthroplasty: A comparative analysis to normal weight patients.Journal of orthopaedics · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHigh 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.
methodsThe 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.
resultsOut 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.
conclusionsA 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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