title: Early experience with the Vanguard complete total knee system: 2-7 years of follow-up and risk factors for revision.
abstract: A cross-sectional study in two hospitals was performed on 807 patients with a primary Vanguard (Biomet) total knee Arthroplasty (TKA). The research questions addressed were (1) what are the two- and six year survival rates of the Vanguard, (2) what are the clinical outcome scores, (3) what are the findings at revision and (4) what are predictors for revision? The mean age at time of surgery was 67.0 (SD 10.0). The mean follow-up was 3.6 years (95% CI 3.56-3.73). At two years the survival was 97.2% for all-reasons (767 patients remaining) and 99%, for prosthesis-related-reasons (777 remaining). At six years this was 96.5% (40 remaining) and 98.6% (41 remaining). The mean clinical results (84% response on KOOS, Oxford and NRS) were good. A previous osteotomy was a risk factor for revision (hazard ratio 5.1, P=0.001). This early experience with the Vanguard shows a good survival with no adverse outcomes related to the implant and therefore further use of the implant is justified.
authors.affiliation: Department of Orthopedics, Orthopaedic Research Center Amsterdam, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Kievit
authors.affiliation: Department of Orthopedics, Orthopaedic Research Center Amsterdam, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Matthias U
authors.initials: MU
authors.lastname: Schafroth
authors.affiliation: Department of Orthopedics, Orthopaedic Research Center Amsterdam, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Leendert
authors.initials: L
authors.lastname: Blankevoort
authors.affiliation: Department of Orthopedics, Slotervaart Hospital, Amsterdam, the Netherlands.
authors.forename: Inger N
authors.initials: IN
authors.lastname: Sierevelt
authors.affiliation: Department of Orthopedics, Orthopaedic Research Center Amsterdam, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: C Niek
authors.initials: CN
authors.lastname: van Dijk
authors.affiliation: Department of Orthopedics, Amphia Hospital, Breda.
authors.forename: Rutger C I
authors.initials: RC
authors.lastname: van Geenen
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Kaplan–Meier survival; Vanguard; revision rates; risk factors; total knee arthroplasty