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The Journal of Bone & Joint Surgery British Volume
Vol. 85-B, Issue 3 | Pages 393 - 398
1 Apr 2003
Siddique MS Rao MC Deehan DJ Pinder IM

We carried out 60 revision procedures for failed porous coated anatomic total knee replacements in 54 patients, which were divided into two groups. The 14 knees in group I had a well-fixed femoral component at surgery which was retained, and in the 46 knees in group II both tibial and femoral components were loose and were revised using a variety of implants. Our review comprised clinical and radiological assessment.

A total of 13 knees required a second revision. Six (42%) in group I failed very early (mean 2.1 years) when compared with seven (15%) in group II (mean 6.8 years). Failure was due to wear of the polyethylene insert by the abraded, retained femoral component (crude odds ratio 4.07; 95% CI 1.07 to 15.5). We recommend a complete change of primary bearing surfaces at the time of revision of an uncemented total knee replacement in order to prevent early wear of polyethylene.


The Journal of Bone & Joint Surgery British Volume
Vol. 81-B, Issue 4 | Pages 660 - 662
1 Jul 1999
Birdsall PD Hayes JH Cleary R Pinder IM Moran CG Sher JL

Between 1992 and 1994 we performed a prospective study of the effect of total knee replacement (TKR) on the health status of 119 patients over the age of 80 years who had had a primary unilateral TKR.

The Nottingham Health Profile was used to assess this before and at three and 12 months after operation. We found a significant improvement in the scores for pain, emotional reaction, sleep and physical mobility at three months. After 12 months, the scores for pain and sleep were well maintained. The other factors had deteriorated slightly but remained better than before operation.

Our findings show that TKR leads to a significant improvement in the general health status of the very elderly.


The Journal of Bone & Joint Surgery British Volume
Vol. 79-B, Issue 5 | Pages 878 - 878
1 Sep 1997
FERDINAND RD PINDER IM


The Journal of Bone & Joint Surgery British Volume
Vol. 78-B, Issue 6 | Pages 907 - 911
1 Nov 1996
Weir DJ Moran CG Pinder IM

We performed an independent survivorship analysis on 208 Kinematic Condylar knee replacements with a minimum follow-up of ten years and a mean of 12 years. Seven patients had been lost to follow-up. At ten years the estimated survival was 92% (95% confidence limits 95% and 87%) and when stratified for diagnosis and thickness of polyethylene there was no statistical difference (p > 0.05) in survivorship of knees with osteoarthritis or rheumatoid arthritis.

We conclude that the original design of the Kinematic Condylar knee replacement has a good record and that adequate evaluation of new designs of implant should be undertaken before they are widely introduced.


The Journal of Bone & Joint Surgery British Volume
Vol. 78-B, Issue 3 | Pages 441 - 445
1 May 1996
Emmerson KR Moran CG Pinder IM

The Kinematic Stabilizer is a posterior-cruciate-substituting design of total knee replacement. We have reviewed 109 primary total knee replacements in 95 patients at a mean follow-up time of 12.7 years (10 to 14). We used survival analysis with failure defined as revision of the implant. This gave a cumulative survival rate of 95% (95% CI± 5%) at ten years and 87% (± 10%) at 13 years.

These results from an independent centre confirm the value of an established design of cemented total knee replacement and question the wisdom of the introduction of modifications and new designs without properly controlled trials.


The Journal of Bone & Joint Surgery British Volume
Vol. 78-B, Issue 1 | Pages 18 - 21
1 Jan 1996
Kreibich DN Moran CG Delves HT Owen TD Pinder IM

We measured the levels of cobalt and chromium in the serum in three groups of patients after uncemented porous-coated arthroplasty. Group 1 consisted of 14 consecutive patients undergoing revision for aseptic loosening. Group 2 comprised 14 matched patients in whom the arthroplasty was stable and group 3 was 14 similarly matched patients with arthritis awaiting hip replacement. Specimens were analysed using atomic absorption spectrophotometry.

Aseptic loosening of a component resulted in a significant elevation of serum cobalt (p < 0.05), but not of serum chromium. The relative risk of a component being loose, if the patient had a serum cobalt greater than 9.0 nmol/l, was 2.8.


The Journal of Bone & Joint Surgery British Volume
Vol. 55-B, Issue 1 | Pages 119 - 125
1 Feb 1973
Pinder IM

1. Anterior synovectomy was undertaken in sixteen knees of fourteen patients with rheumatoid arthritis associated with popliteal or calf cysts. Subsequent changes in the knees and cysts were observed clinically and by arthrography.

2. In all instances there was alleviation of symptoms and in fourteen cases the cysts disappeared.

3. It is suggested that anterior synovectomy is the logical treatment of a posterior cyst associated with rheumatoid arthritis of the knee.