The purpose of the current study was to evaluate the authors' 15-year exper
ience with the Anatomic Graduated Components total knee replacement. This i
s a report of the survivorship of 4583 Anatomic Graduated Component total k
nee arthroplasties. Kaplan-Meier survival analyses were performed with the
end point defined as radiographic loosening, revision, or both. This end po
int was subdivided into the best case scenario in which it was assumed that
all the patients lost to followup were doing well throughout the study and
a worst case scenario in which it was assumed that all patients lost to fo
llowup had failed results at their last clinic visit. There were six (0.18%
) femoral, 21 (0.46%) tibial, and 180 (4.2%) all-polyethylene patellar comp
onent failures secondary to aseptic loosening. All femoral components and 9
0% of the tibial components were revised; however, only 15 patellar compone
nts were revised. The clinical survival rate with revision of one or more o
f the components was 98.86% at 15 years. Despite having nearly flat-on-flat
geometry and retaining the posterior cruciate ligament, which should incre
ase the stresses in the polyethylene and at the bone-cement interface, this
total knee replacement has proved to have minimal wear and excellent longe
vity with time. The authors think this is a result of the direct compressio
n molded polyethylene articulation and the nonmodular configuration that in
corporates metal backing on the tibial component and eliminates back-sided
tibial component polyethylene wear.