Long-term followup of the bone-ingrowth ortholoc knee system without a metal-backed patella

Between June 1981 and January 1984, 265 Ortholoc-I femoral and tibial compo nents were implanted using bone-ingrowth technique in 202 patients. Five kn ees (five patients) were lost to followup and 66 knees were excluded becaus e the patients died, leaving 184 knees (165 patients) with 15 to 18 years f ollowup. One knee loosened during the 15- to 18-year followup period and wa s revised, and five knees were revised for infection. Survival rate at 18 y ears considering loosening was 98.6%. At 15 years after surgery, 79.9% of p atients did not have pain, 10.1% had mild pain, 8% had moderate pain, and 2 % had severe pain. At 18 years after surgery, 77.6% did not have pain, 7.2% had mild pain, 5.2% had moderate pain, and 1% had severe pain. Knee flexio n was 110 degrees preoperatively and increased to a mean of 115 degrees at 2 years postoperative, then remained unchanged for the rest of the followup . Intramedullary alignment proved to be highly effective, and has become th e standard for total knee arthroplasty instrumentation systems. Total knee replacement with bone-ingrowth technique was a reliable and effective means of treating the end-stage arthritic knee. In patients who required revisio n surgery, excellent bone stock remained and revision with bone-ingrowth te chnique was accomplished easily.