This paper reports the clinical outcomes and survivorship of a prospective series of Advantim cementless TKR performed at the RAH between 1993 and 2005. There were 210 knees in 176 patients. All procedures were performed or supervised by a single surgeon.

All patients were followed up at regular intervals, up to 15 years later, with Knee Society Cinical Rating System and X-Rays. No patients were lost to follow-up. The knee rating improved from a median of 47 to 90. The median range of motion was 0–100. At 11 years the survivorship of the tibial component was 95.5% and femur was 93.7%. There were two major revisions and three minor revisions for polyethelene exchange. There was no deep sepsis. There was no knee stiffness requiring arhrolysis or manipulation. No screw osteolysis observed. Advantim was the best perfoming TKR in the AOA registry in 2008 with 0.3 revisions per 100 observed component years.

Between 1990–92, 59 Primary TKA’s were performed in 55 Patients with a mean follow-up of 9 years (8–10). Mean age at review was 75 years (61–87). Materials and Method: All cementless TKA’s (Whiteside Ortholoc Modular 3). One surgeon (operating or supervising). Intramedullary guides(tibia and femur). Lateral retinacular release. Clinical evaluation according to the Knee Society Scoring System & Knee Society TKA Roentgenographic Evaluation and Scoring System. Median Knee Score 93.5 (41–97). Median Functional Score 77.5 (35–100). Median flexion 100 degrees (80–120). All but one knee came to full extension. No effusions or swellings. Radiolucencies in one TKA only. Discussion: Long term success of TKA’s (cementless or cemented) depends on correct alignment of the implants. Rigidity of fixation is the second most important feature in achieving pain free function in an arthroplasty. Success in this series was due to good alignment of components. Good alignment minimises polyethelene wear. Rigid tibial fixation prevents motion, tilting and malalignment reducing wear.