Purpose : The purpose of our study is to present, our long term experience of a total knee joint arthroplasty using a mobile bearing polyethylene platform.

Material and Method : From 1990 to 1998 we operated 324 knees in 259 patients. During the last follow-up 301 knees were assessed in 241 patients.

7 patients died (9 knees) and 11 patients did not attend.

The postoperative follow-up time ranged from 4–12 years (average 8,5 yrs).

207 patients were women (265 knees) and 34 were men (36 knees) aged from 20 to 82 years (average 67,2yrs) at the time of operation.

275 patients suffered from osteoarthritis, 23 from rheumatoid arthritis and 3 from avascular necrosis.

Results : The preoperative and postoperative evaluation was done according to the British Orthopaedic Association Knee Assessment Chart. The knee pain was improved in all of our patients. The knee flexion was improved from an average of 87° pre-op to an average of 113° post-op.

The pre-op valgus deformity was corrected in 24 from 26 knees and the varus was corrected in 157 from 172 knees.

Postoperative alignment was achieved in 286 knees (94,65%).

Radioluscent line was observed in 14 knees (in 6 knees < 1mm and in 8 knees 1–2mm of thickness).

There were 7 complications of the prosthesis needing re-operation.

In 6 cases wear and breakage of the polyethylene and in 1 dislocation of the meniscus was confirmed.

Conclusion : The Rotaglide T.K.R is a reliable solution with satisfactory long-term results. The prosthesis design allows correction of a small rotational malalignment of the femoro–tibial axis. In our patients we did not observe any component loosening and there was no need for re-operation and metal component replacement.

We recommend the use of Rotaglide total knee replacement in more active and biologically young patients when needed.

The choice of the surgical exposure in total hip arthroplasties for osteoarthritis is a significant parameter for a successful outcome.

The aim of this study is to evaluate complications or/and advantages related to the most often used approaches for total hip arthroplasties: the direct lateral or transgluteal (Hardinge) and the posterior (Moore) one.

During the period 1997–2000, 50 patients with lateral approach and 50 patients with posterior approach were randomly selected from a pool of 394 total hip arthroplasties (382 patients). Patients with surgery of the contralateral hip were excluded. The mean age of the patients was 72 years (62–84 years) and the indication was degenerative osteoarthritis. The operating time and the postoperative, early and late, complications were studied. The average follow-up was 18 months (12–24 months) and included clinical and radiographic control.

The mean operating time was 76 min. (63–91 min.) and 92 min. (83–110 min.) for lateral and posterior approach, respectively. Complications (early and late) associated with transgluteal approach were 16 patients with positive trendelenburg sign, which disappeared within one year post op, 8 with sympathetic knee effusion which subsided within 6 weeks, 2 with ectopic periarticular ossification and 1 with severe thigh pain. In total hip arthroplasties with posterior approaches, 4 cases were complicated with ectopic ossification, 3 with sympathetic knee effusion which subsided within 4 weeks, 2 with posterior dislocation which needed revision surgery and 2 with peroneal nerve paresis which recovered within 6 months. Except for the trendelenburg sign (p< 0.001), all the other complications did not differ statistically significantly (p> 0.05).

In conclusion, the posterior approach seems to be related with more severe postoperative complications compared to the transgluteal approach. The gluteus medius’ loss of strength (responsible for limping in equal legs’ length), could be treated with prompt strengthening of the muscle within the first postoperative year.