To estimate the outcomes after posterior dynamic stabilization in situ with Dynesys (Zimmer Spine, Minneapolis, MN) for treatment of symptomatic spinal stenosis and degenerative spondylolisthesis in long-term follow-up.

28 patients(mean age 73 years old) with symptomatic spinal stenosis and spondylolisthesis underwent inter-laminar decompression and stabilization with Dynesys. Patients were evaluated clinically and radiologically after a follow-up from 6 months to 4 years.

Pain on VAS and walking distance improved significantly at less than 2 years and remained unchanged at 4 years follow-up. Radiographically, spondylolisthesis did not progress and the motion segments remained stable. 2 patients showed screw-loosening at 1 year follow-up and underwent revision. Overall, patient satisfaction remained high as 93% and would undergo the same procedure again.

In elderly patients with spinal stenosis and degenerative spondylolisthesis, decompression and dynamic stabilization lead to excellent clinical and radiologic results. It maintains enough stability to prevent progression of spondylolisthesis. Because no bone grafting is necessary, donor site morbidity, which is one of the main drawbacks of fusion is eliminated

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.