title: Cemented fixed-bearing PFC total knee arthroplasty: survival and failure analysis at 12-17 years.
abstract: BACKGROUND
  Total knee arthroplasty (TKA) is the appropriate treatment for degenerative pathology of the knee. Implant surveillance is mandatory to improve clinical results. We present the long-term results of a series of consecutive TKA Press Fit Condylar (J&J), cemented fixed bearing with selective patellar resurfacing in nonselected patients.
  
  
  METHODS
  In this prospective case series, 223 TKA were clinically and radiographically evaluated using the Hospital for Special Surgery (HSS) knee score and the Knee Society Roentgenographic Evaluation and Scoring System.
  
  
  RESULTS
  There were 197 patients, with an average age of 68.4 years [95% confidence interval (CI) 52.7-84.1 years]; 49 arthroplasties were implanted in men (21.1%) and 184 (78.9%) in women. The average follow-up was approximately 13.5 years (162.1 months; 95% CI 132.3-191.9), and it was possible to evaluate 179 implants (76.8% of the implanted prosthesis) in 176 patients. The average HSS score increased from 61.5 (95% CI 60.4-62.7) to 89.4 (95% CI 87.7-.93.5) points. The cumulative average survival rate at 15 years (the endpoint being failure with revision) was 90.6%  ± 2% standard deviation. Resurfacing the patella did not make a difference in terms of implant survival. Progressive radiolucent lines were observed around 20 implants (14.3%); all were revised.
  
  
  CONCLUSIONS
  The PFC system is an excellent prosthetic solution. Early clinical complications, mechanical axis and patellar resurfacing do not correlate with implant failure, whereas progressive radiolucent lines do.
authors.affiliation: Department of Orthopedics and Traumatology, CTO/M. Adelaide Hospital, Turin, Italy. alessandro.bistolfi@cto.to.it
authors.forename: A
authors.initials: A
authors.lastname: Bistolfi
authors.forename: G
authors.initials: G
authors.lastname: Massazza
authors.forename: F
authors.initials: F
authors.lastname: Rosso
authors.forename: D
authors.initials: D
authors.lastname: Deledda
authors.forename: V
authors.initials: V
authors.lastname: Gaito
authors.forename: F
authors.initials: F
authors.lastname: Lagalla
authors.forename: C
authors.initials: C
authors.lastname: Olivero
authors.forename: M
authors.initials: M
authors.lastname: Crova
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001843:Bone Cements / Q000627:therapeutic use*; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010027:Osteotomy / Q000379:methods; D010329:Patella / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D011859:Radiography; D013997:Time Factors
chemical_list: D001843:Bone Cements