title: Primary meniscal-bearing knee replacements: 8- to 15-year followup.
abstract: This study presents the survivorship data of a consecutive series of primary meniscal-bearing total knee replacements at one institution at 8 to 15 years followup. We reviewed 125 meniscal-bearing knee replacements in 93 patients at a minimum followup of 96 months (mean, 130 months; range, 96-191 months). The tibial and femoral components were cemented in 71 knees; uncemented femurs and tibias were used in 48 knees; and cemented tibias and uncemented femurs were used in six knees. One patient was lost to followup. Seventeen knees failed, three as a result of infection. Five knees were revised for loose tibial components and one for a loose femoral component. A second femoral component was identified as radiographically loose. All the loose components were uncemented. Five knees had reoperation for fractured bearings and one for a dislocated bearing. This knee was later rerevised for a loose uncemented tibia. One knee was revised for instability and a second knee was identified as grossly unstable but not revised. Kaplan-Meier survival analysis showed survivorship of approximately 90% at 9 years, which decreased to 71% at 15 years. Uncemented components had an increased aseptic loosening rate compared with cemented components. Meniscal-bearing replacements with cement fixation appeared successful, although bearing fracture seems to be a predominant failure mode at long-term followup.
authors.affiliation: Division of Orthopaedic Surgery, Lexington Veteran's Hospital, Lexington, KY, USA. hartfoj@pamf.org
authors.forename: James M
authors.initials: JM
authors.lastname: Hartford
authors.forename: Michael E
authors.initials: ME
authors.lastname: Harned
authors.forename: Herbert
authors.initials: H
authors.lastname: Kaufer
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Dobner
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Nicholls
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000295:instrumentation*; D002484:Cementation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D013314:Stress, Mechanical; D013997:Time Factors; D016896:Treatment Outcome; D016474:Weight-Bearing