Long Term Follow-up Results of Total Knee Arthroplasty

ABSTRACT

PURPOSE: We purpose to analyse the clinical and radiologic results of total knee arthroplasty and long term survival rate and to assess the cause of failure. MATERIALS AND METHODS: We retrospectively investigated 156 TKAs(110 patients) from January 1985 to March 1992 followed up for more than 10 year. These series of 110 patients included 20 men and 90 women, the mean follow-up period was 12 years 3 months(range 10~18 years). In primary diagnosis, there were Degenerative Arthritis (DA) 105 knees, Rheumatoid Arthritis(RA) 45 knees, others 6 knees. Of 156 knees, there were 139 Cruciate-Retaining type(CR), and 17 Posterior-Stabilized type(PS). Both femoral and tibial component were fixed with cement in 71 knees, 15 knees were fixed without cement, and only one component was fixed with cement in 70 knees(Hybrid). Press Fit Condylar(PFC) prosthesis were 133, Miller Galante(MG) were 16, and others 7. 16 cases of patella were preserved and 140 knees were resurfaced. The clinical outcome was evaluated according to the HSS and American Knee Society scoring system and radiologic analysis was made by tibiofemoral angle and radiolucent line by American Knee Sociey system. Results: The HSS score was improved from 51.7 to 86.4 and ROM was improved from 101.3 degrees to 111.7 degrees. The last ROM was improved in DA group than RA, and HSS score of PFC prosthesis was higher than Miller-Galante. The failure were seven(5.3%) in PFC, but seven(43.8%) in MG. The survival rate was 93.0% after 10 years, and 88.8% after 14 years when the endpoint was defined as revision arthroplasty. The arthroplasty fails due to wear, aseptic loosening and deep infection and patellofemoral complication. CONCLUSION: The total knee arthroplasty is a safe, durable, and predictable procedure and has a long survivorship if we select the proper prosthesis.