Total knee arthroplasty with the PFC system - Results at a minimum of ten years and survivorship analysis

A consecutive series of 235 total knee arthroplasties using the PFC system was followed prospectively for at least ten years in 186 patients. The oper ation was for osteoarthritis in 150 knees, for rheumatoid arthritis in 83, and for Paget's disease and femoral osteonecrosis in one knee each. At the latest review 56 patients had died, five were too ill to assess and three c ould not be traced. The PFC knee replacement utilised was a non-conforming posterior-cruciate-r etaining prosthesis with a polyethylene insert which is flat in the sagitta l plane. The patella was resurfaced using a metal-backed component in 170 c ases, but later in the series we used an all-polyethylene component in 22 k nees; 43 patellae were not resurfaced. The survival without need for reoper ation for any reason was 90% at ten years, Nineteen revisions were componen t-related due to failure of nine metal-backed patellae, nine polyethylene i nserts, and one unresurfaced patella; two reoperations were for synovectomy tone for recurrent haemarthrosis and one for recurrent rheumatoid synoviti s) and three were for metastatic joint infection. There were no revisions f or aseptic loosening of femoral or tibial components, or the all-polyethyle ne patellar replacement. The PFC system provides good and predictable results in tricompartmental ar thritis of the knee. Loosening appeared to be negligible, but there were we ar-related problems in 8%. The change from a metal-backed patella and an in crease in the contact area of the tibial insert should provide further impr ovement by minimising wear.