title: Total knee arthroplasty at 15-17 years: does implant design affect outcome?
abstract: OBJECTIVE
  A study was conducted to compare minimum 15-year survivorship and outcome of the Genesis I and II implants for total knee arthroplasty (TKA).
  
  
  METHODS
  We retrospectively reviewed 245 consecutive TKA implanted between January 1995 and October 1997. Genesis I was implanted in 156 knees and Genesis II in 89 knees.
  
  
  RESULTS
  At 15-17 years, 75 patients (31%) had died, 28 patients (11%) were lost to follow-up and 11 TKA were revised (4.6%), including ten Genesis I (6.4%) and one Genesis II (1.1%); 131 TKA (53%) were available for follow-up. Cumulative survivorship was 92.4% at 15.7 years. Survival in patients <69 years at surgery was lower (88.0%) compared with patients ≥69 years (98.5%; p = 0.023). In patients <69 years, Genesis I survival (84.3%) was worse compared with Genesis II (97.1%) (p = 0.018). Polyethylene (PE) Insert thickness ≤11 mm had significantly better survivorship (97.1%) compared with PE >11 mm (56.7%) (p < 0.0001) CONCLUSIONS: At a minimum of 15 years, the overall (92.4%) survivorship of Genesis TKA was good, with excellent (98.1%) survivorship of the Genesis II design. Revision rates were higher with Genesis I in the younger age group and with insert thickness >11 mm, possibly due to longer shelf life of less frequently used sizes.
authors.affiliation: Department of Orthopaedics and Traumatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium, Jan.Victor@UGent.be.
authors.forename: Jan
authors.initials: J
authors.lastname: Victor
authors.forename: Stijn
authors.initials: S
authors.lastname: Ghijselings
authors.forename: Farhad
authors.initials: F
authors.lastname: Tajdar
authors.forename: Geert
authors.initials: G
authors.lastname: Van Damme
authors.forename: Patrick
authors.initials: P
authors.lastname: Deprez
authors.forename: Nele
authors.initials: N
authors.lastname: Arnout
authors.forename: Catherine
authors.initials: C
authors.lastname: Van Der Straeten
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007719:Knee Joint / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome