title: Cemented rotating-platform total knee replacement: a concise follow-up, at a minimum of twenty years, of a previous report.
abstract: We previously evaluated 119 consecutive total knee arthroplasties performed by a single surgeon in eighty-six patients with use of the cemented LCS (low contact stress) mobile-bearing, rotating-platform system and an all-polyethylene patellar component. The average age of the patients at the time of surgery was seventy years. The patients were contacted as part of their routine follow-up and were asked to participate in this study. The purpose of the present study was to report the updated results at a minimum follow-up of twenty years. Twenty patients (twenty-six knees) were living, and one was lost to follow-up. Three knees required a reoperation (two for periprosthetic fractures and one for infection). No component was revised as a part of the reoperations. No knee required revision since the fifteen-year follow-up evaluation. Osteolysis was present in six knees compared with only three knees at the time of the fifteen-year follow-up. One knee had radiographic signs of femoral component loosening, which was associated with osteolysis. It occurred after the fifteen-year follow-up study. The average range of motion was from 1 degrees of extension to 105 degrees of flexion. The average clinical and functional Knee Society scores were 43 and 49 points, respectively, at the preoperative evaluation and 89 and 67 points at the time of the final follow-up. We concluded that the cemented LCS rotating-platform knee performed well, with durable clinical and radiographic results at a minimum follow-up of twenty years. However, the prevalence of osteolysis continues to increase with a longer duration of follow-up in these patients.
authors.affiliation: University of Iowa and VA Medical Center, 200 Hawkins Drive, UIHC, 01029 JPP, Iowa City, IA 52242, USA. john-callaghan@uiowa.edu
authors.forename: John J
authors.initials: JJ
authors.lastname: Callaghan
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Wells
authors.forename: Steve S
authors.initials: SS
authors.lastname: Liu
authors.forename: Devon D
authors.initials: DD
authors.lastname: Goetz
authors.forename: Richard C
authors.initials: RC
authors.lastname: Johnston
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001843:Bone Cements; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging; D007720:Knee Prosthesis; D008875:Middle Aged; D010014:Osteolysis / Q000209:etiology; D011859:Radiography; D016059:Range of Motion, Articular; D012086:Reoperation
chemical_list: D001843:Bone Cements