The kinematic total knee arthroplasty. A 10- to 15-year follow-up and survival analysis.
In 86 patients 102 consecutive cemented Kinematic total knee arthroplasties were reviewed 10-15 years after surgery to determine the clinical and radiographic results and to assess the survival rate. The average age of the 65 female and 21 male patients at the time of surgery was 63 years. Forty-six knees were affected by rheumatoid arthritis (RA), 46 by osteoarthritis (OA), 7 by haemophilic arthropathy and 3 by osteonecrosis. One patient (1 knee) was lost to follow-up, and 31 patients (38 knees) died. Eleven knees had been revised for deep infection (4), wear (4), malposition (2) or persistent pain (1). Fifty-two knees were examined at an average follow-up period of 12 years. The mean Knee Society Score of 89 points was the same for RA and AO knees. Also, 92% of the knees caused no pain or only occasional mild pain. There were no cases of aseptic loosening of any component. Progressive radiolucent lines were not seen on the follow-up radiographs (43 knees, mean follow-up 12 years) The 10- and 14-year survival rates with revision as the end-point were 90% (confidence interval, CI: 81%-95%) and 82% (CI: 67%-92%), respectively. In the worst case scenario, with knees lost to follow-up and knees with moderate pain considered as failures, the 10- and 14-year survival rates were 80% (CI: 69%-88%) and 62% (CI: 46%-77%), respectively. The Kinematic total knee arthroplasty yields equally good long-term results in patients with RA and those with OA. Deep infection and wear were the main reasons for revision.
van Loon
C J
CJ
Department of Orthopaedics, University of Nijmegen, The Netherlands.
Wisse
M A
MA
de Waal Malefijt
M C
MC
Jansen
R H
RH
Veth
R P
RP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D012086:Reoperation; D016019:Survival Analysis