REVISION TOTAL KNEE ARTHROPLASTY WITH CO-ORDINATE ULTRA PROSTHESIS: MEDIUM TERM RESULTS (MINIMUM FIVE YEARS)

Abstract

Introduction: The principles of revision arthroplasty are to understand the cause of failure, adequate surgical exposure, restoration of limb alignment, achieving appropriate soft tissue balance, correct implant alignment, restoration of joint line and a good range of motion. Revision knee Arthroplasty is a technically and economically demanding procedure and its successful performance requires thorough preoperative planning, adherence to the principles, availability of diverse implant options and adequate bone graft.

Aim: We prospectively assessed the survivorship of Coordinate Ultra prosthesis (DePuy, Warsaw, Ind) used for revision knee arthroplasty.

Materials and Methods: Fifty-three patients had revision knee replacement performed by the senior author between April 1999 and September 2001. Seven patients (7 knees) had died. At a mean follow-up of 6 years (range: 5–7years), 46 knees in 42 patients were available for review. None were lost to follow-up. There were 31 women and 11 men, with a mean age of 74.2 years. The reason for revision was instability in 39 knees, infection in 3 knees, pain in 2 knees and stiffness in 2 knees.

Results: Significant improvement was noted in the SF-12 PCS and WOMAC pain and stiffness scores at the latest follow-up. None of these patients required re-revision. Radiological evaluation was done using the Knee Society system. None of the knees showed evidence of progressive loosening. Radiopaque lines were found around the stems and were present in immediate post-operative radiographs; this did not indicated loosening or infection on further follow-up. Cumulative survival analysis (Kaplan Meier method) was 100% at 7 years.

Conclusion: Clinical and radiological outcome analysis has revealed that the Co-ordinate Ultra revision knee system continues to function satisfactorily at a mean follow-up of 6 years.