title: Introduction of total knee arthroplasty in Lithuania: Results from the first 10 years.
abstract: OBJECTIVE
  We have previously reported that the first 10 years of hip arthroplasty in Lithuania resulted in a higher cumulative revision rate than that observed in Sweden. We thus compared the corresponding results after introduaction of total knee replacement in Lithuania.
  
  
  METHODS
  The 10-year revision rate for the first 595 primary ScanKnee arthroplasties inserted in Klaipeda, Lithuania, was compared to that for the first 1,280 ScanKnee primary arthroplasties inserted in Sweden. As in the hip replacement study, only patients with osteoarthritis (OA) were included. Primary knee arthroplasties without patellar resurfacing were included, and the endpoint was revision for any reason other than addition of a patellar component.
  
  
  RESULTS
  We found that the cumulative revision rate was not statistically significantly different between the groups. The revision pattern was different, however, and we observed 24 isolated patellar component additions in Sweden, but none in Klaipeda.
  
  
  CONCLUSIONS
  Contrary to the results of our previous hip arthroplasty study, the cumulative revision rate after total knee arthroplasty was similar in the two groups. This suggests that compared to hip arthroplasty, the outcome of total knee arthroplasty was less dependent on surgical experience. The large difference regarding isolated patellar component additions may be explained by long-term accumulation of severe OA cases in Lithuania. To patients subject to a newly introduced surgical treatment offering great improvement in quality of life, patellofemoral pain may be a minor problem. Furthermore, patellar problems may not have seemed particularly relevant for the surgeons, considering the disability of other patients waiting to be treated.
authors.affiliation: Department of Orthopedics, Kaunas Medical University, Kaunas, Lithuania, Sweden. sarunas.tarasevicius@med.lu.se
authors.forename: Sarunas
authors.initials: S
authors.lastname: Tarasevicius
authors.forename: Justinas
authors.initials: J
authors.lastname: Stucinskas
authors.forename: Otto
authors.initials: O
authors.lastname: Robertsson
authors.forename: Hans
authors.initials: H
authors.lastname: Wingstrand
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007720:Knee Prosthesis; D008097:Lithuania; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery; D017063:Outcome Assessment, Health Care; D011475:Prosthesis Failure; D012086:Reoperation; D013548:Sweden