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The use of trabecular metal in the tibial surface may increase prosthetic survival in the population with severe or morbid obesity (BMI > 35 kg/m2). A prospective, descriptive study was conducted of patients with a BMI > 35 kg/m2 who underwent total knee replacement with a prosthesis with trabecular metal. Minimal follow-up was two years. The statistical analysis was done with Student's t test; the Knee Society Score and the Western Ontario and McMaster Universities Osteoarthritis Index were applied preoperatively and postoperatively. The chi2 test was applied to the BMI values relating them with more or less radiolucent images. The total number of patients was 39, but three were excluded for not having the radiographic follow-up. Mean follow-up was 34 months (25-43); 35 were females, mean age was 69.4 years (57-81), mean BMI was 39.43 kg/m2 (35-55). All patients had grades 3 and 4 tricompartmental arthrosis. The KSS (R and F) and WOMAC scales, with a 95% confidence interval, showed a statistically significant improvement in the assessment of preoperative results and at the end of the followup. Only a few studies measure long-term implant survival. Most authors define survival as the absence of the need to revise prosthetic implants. The end point of survival is the removal or exchange of prosthetic components. Trabecular metal (TM) is currently used in orthopedic surgery and its clinical applications are increasing more and more with good results.

Objective: To calculate whether the introduction for systematic use of an epicrisis form for deaths improved the quality of mortality records in a primary care centre (PCC)., Design: Before and after study., Setting: Urban, with a population of 31 000. Patients and other participants. All the deaths recorded at the PCC before 1996 (N=396) and in the period from January 1999 to August 2000 (N=160)., Main Measurements and Results: The number of deaths recorded at the PCC represents only 32.5% of the official data obtained from the municipal registry in the 1996 evaluation, and 51.5% in the 2000 evaluation. In 2000 the epicrisis forms were filled out in 76.8% (95% CI, 65.0-88.6%) of all deaths. In the 1996 evaluation the place of death was not recorded in 65.5% (95% CI, 59.0-71.8%) of cases, but in 2000 this figure was 22.5% (95% CI, 19-26%). Undefined causes of death dropped from 37% (95% CI, 33.4-40.6%) in 1996 to 30.5% (95% CI, 25.8-35.2%) in 2000. Recording of cause of death rose from 64% (95% CI, 57.8-70.4%) in 1996 to 73% (95% CI, 61.8-84.4%) in 2000., Conclusions: Official data reveal under-recording of mortality at the PCC. The introduction of an epicrisis form for deaths has improved the quality of the centres mortality records.