Is Utilizing a Modular Stemmed Tibial Component in Obese Patients Undergoing Primary Total Knee Replacement Cost-Effective?


  • J. Ryan Martin OrthoCarolina
  • Jesse Otero University of Iowa
  • Walter Beaver OrthoCarolina
  • Bryan Springer OrthoCarolina
  • William Griffin OrthoCarolina



Obesity, Total knee arthroplasty, Cost calculator, Stemmed tibial component, Cost-effectiveness


Introduction: There has been recent enthusiasm for the use of modular stemmed tibial components in obese (BMI ?35kg/m2) patients undergoing primary total knee arthroplasty (TKA). This has been mainly driven by studies demonstrating statistically significant increases in the rates of aseptic tibial loosening (ATL) in this patient population. However, to our knowledge, no study has specifically evaluated the cost effectiveness of this current recommendation.

Methods: The following study was performed utilizing previously obtained data on the incidence of ATL in obese patients undergoing primary TKA. This data was then utilized to create a cost calculator that can evaluate the price point at which the use of a stemmed tibial component in all obese patients would be less than or equal to the costs of revision surgery if a stemmed implant was not utilized.

Results: Utilizing historical data with a revision rate of 4% for aseptic loosening of the tibia on obese patients, a cost calculator was developed. The cost calculator requires the input of expected or known incidence of ATL utilizing a stem extension and the expected or known costs of revision for ATL.

Conclusion: The following cost calculator quickly determines a price point at which the use of a tibial stem offsets the costs of revision surgery. While this study may not provide an exact cost-effectiveness of modular stem fixation due to model limitations, it will hopefully initiate the discussion for providing more cost-effective individualized care for this patient population.


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How to Cite

Martin, J. R., Otero, J., Beaver, W., Springer, B., & Griffin, W. (2018). Is Utilizing a Modular Stemmed Tibial Component in Obese Patients Undergoing Primary Total Knee Replacement Cost-Effective?. Reconstructive Review, 8(2).



Original Article