Abstract
Introduction The efficacy of total knee replacement (TKR) surgery is well documented throughout the literature. Results from cemented and cementless series reveal similar long-term reliable results in terms of function and survival. Less, however, is known of the long-term results of uncemented TKR with the use of hydroxyapatite (HA). The purpose of this paper is to present the long-term results of a series of TKR using an uncemented, HA-coated, PCL retaining prosthesis.
Method During the period from August 1992 to December 1994 all patients undergoing TKR surgery were prospectively recorded in a consecutive series. Results were recorded pre- and post-surgery at regular intervals (both clinically and radiographically). The combined clinical Knee Society Score was used to evaluate outcome with routine radiographic evaluation done at 10 years.
Results 217 patients (126 female, 91 male) were included in the study with 322 knees in total (75 simultaneous bilateral, 23 staged bilateral and 126 unilateral). The mean age was 70 years (range 34–88 years) with a mean follow-up of 11 years (range 10–12 years). 47 (21.7%) patients were deceased at 10 years. The principle indication for surgery was osteoarthritis. There has been 1 revision (0.3%) for infection in this series to date. There have been 7 (2.2%) deep infections requiring surgical intervention and 4 (1.2%) supracondylar fractures.
At 10 years, mean knee score was 174 with range of movement 0–111 degrees. 95.4% of the series has currently been successfully followed up. 9 patients were unable to be contacted and lost to follow up. With revision as an end point, the rate of survival for the prosthesis at 10 years is 99.4%. Assuming worst case scenario for patients lost to follow up, survivorship is 95.4%.
Conclusion The survival of this prosthesis has shown to compare favourably to other published results. A low rate of revision and infection combined with excellent clinical and functional outcomes suggests the use of HA with an uncemented TKR produces reliable long-term results.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
