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CO-ORDINATE PROSTHESIS FOR REVISION KNEE ARTHROPLASTY: RESULTS OF 9–12 YEAR FOLLOW-UP



Abstract

We reviewed the clinical and radiological outcome of 72 Co-ordinate prostheses (DePuy, Warsaw, Ind) used for revision knee arthroplasty performed by a single surgeon from May 1994 to December 1997. Twenty-three patients (25 knees) since died. Two were lost to follow-up. At a mean follow-up of 10 years (range 9–12years), 45 knees in 43 patients were available for review. There were 12 men and 31 women with a mean age of 71.34 years (range 43 to 87 years). The reason for revision was instability in 38 knees, infection in 5 knees and stiffness in 2 knees.

There was a significant improvement in the SF-12 PCS and WOMAC pain and stiffness scores at the latest follow-up. Five of these knees had to have re-revision surgery. One patient had a re-revision for aseptic loosening, one patient for recurrent dislocation of patella. Three patients underwent repeat procedures for infection.

Radiological evaluation using the Knee Society system revealed well-fixed components in 35 knees (77.78%). The radiolucencies of varying degrees were present in 10 knees (22.22%). Eight had non-progressive radiolu-cencies and did not show any evidence of loosening. 25 (55.5%) knees had halo sign (radiopaque line) present around the prosthesis (7 were femoral side, 4 were tibial side and 14 around both the prosthesis). Using Kaplan Meier method the cumulative survival rate was 88.87% at 12 years, removal of the prosthesis or re-revision were used as end points. An analysis of clinical and standard radiographic outcomes has revealed that the Co-ordinate revision knee system continues to function satisfactorily at a mean of 10 years.

Correspondence should be addressed to: Tim Wilton, BASK, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.