TOTAL KNEE ARTHROPLASTY WITH THE KINEMATIC CONDYLAR PROSTHESIS - A 10-YEAR FOLLOW-UP-STUDY

Of 168 consecutive knees (118 patients) that had been treated with an arthroplasty with use of a kinematic total condylar prosthesis that al lowed retention of the posterior cruciate ligament, 119 knees (eighty- four patients) were available for review at a mean of 10.0 +/- 0.7 yea rs after the operation. The Hospital for Special Surgery knee score im proved significantly, from a mean of 55 +/- 12 points preoperatively t o a mean of 81 +/- 9 points at ten years (p < 0.0001). Radiolucent lin es about the patellar component, present in thirty five of eighty-thre e knees at the latest follow-up examination, were related to malpositi oning of the tibial and femoral components. Six revisions were perform ed, and four of them were for a loose patellar component. The rate of deep infection was 1 per cent (one knee). Complications occurred in tw enty-six knees (22 per cent), With revision as the end point, the rate of survival of the prostheses was estimated to be 96 per cent at ten years. The knee scores, the rate of survival of the implants, and the range of motion of the knees in the current study were similar to thos e reported previously for patients who had insertion of a total condyl ar prosthesis with sacrifice of the posterior cruciate ligament and fo r those who had substitution of the posterior cruciate ligament with a posterior stabilized prosthesis. A prosthesis that has a metal-backed tibial component and that allows preservation of the posterior crucia te ligament provides durable results, but loosening of the patellar co mponent remains a major problem.