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CONSECUTIVE SERIES OF 1188 TOTAL KNEE ARTHROPLASTY PROCEDURES: IS WEAR A CONCERN?



Abstract

This study presents the results of 1188 original and innovative posteriorly stabilized TKA procedures in which the femoral bone stock is preserved with a shallow compartment insofar as possible. The TKA procedure is directly derived from Insall’s original technique, except for the posterior stabilisation design, where a third median condyle starts working at 30° of knee flexion.

A total of 1188 primary TKA procedures were consecutively performed in a university hospital. Average follow-up was 30 months (0–168 months). The implants were cemented (except for 35 femoral components) and the patella resurfaced (except for nine cases). Clinical results were assessed using the IKS Score. The quality of the implantation was analysed on long-leg X-rays (1175 preoperative and 883 postoperative long-leg films available at follow-up). The results showed that 95% of patients were very satisfied or at least satisfied. Knee score and functional scores were 44 and 54 preoperatively and 90 and 78 postoperatively. Mean range of motion was 116°. On X-ray analysis, the average mechanical femorotibial angle was 179° postoperatively. Survival of the implant for revision was 94.2% at 14 years. We performed 83 re-operations (nine patellar fractures, 14 infections, 12 cases of stiffness and 11 clunck syndromes), including 33 component revisions.

Clinical results compared favourably with the literature. This original posterior stabilisation design confirmed the good and excellent results at follow-up. We obtain good range of motion, and no revision was due to polyethylene wear.