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The Scientific World Journal
Volume 2012, Article ID 249391, 5 pages
Clinical Study

Better Outcomes in Severe and Morbid Obese Patients ( B M I > 𝟑 𝟓 k g / m 𝟐 ) in Primary Endo-Model Rotating-Hinge Total Knee Arthroplasty

1Knee Surgery Unit, Orthopaedic Department, Hospital Clínic, Universitat de Barcelona, 08036 Barcelona, Spain
2Orthopaedic Department, Hospital Dos de Maig, 08025 Barcelona, Spain
3Laboratory of Biostatistics & Epidemiology, Universitat Autonoma de Barcelona and IDIBAPS, 08036 Barcelona, Spain
4Orthopaedic Department, Consorci Sanitari Parc Taulí, 08208 Sabadell, Spain

Received 16 October 2011; Accepted 9 January 2012

Academic Editors: L. J. Catoggio and C. C. Mok

Copyright © 2012 Luis M. Lozano et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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/m2) 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.