title: 2- to 9-year outcome of stemmed total knee arthroplasty. Similar failure rates in patients when used primary or as a revision.
abstract: OBJECTIVE
  There is an increase in demand for primary and revision total knee joint procedures. We studied implant survival and functional outcome of patients operated with a constrained condylar knee (CCK) or a rotating hinge implant (RH) as a primary or a revision total knee arthoplasty (TKA).
  
  
  METHODS
  We evaluated clinically and radiographically 65 surgical procedures with a mean follow-up time of 5 (2-9) years (40 CCK and 25 RH). There were 24 primary TKAs-due to instability-and 41 revision TKAs, mostly due to aseptic loosening. Mean age at the index operation was 68 (31-88) years.
  
  
  RESULTS
  Overall, there were 12 failures, including 8 reoperations due to deep infection. The overall 5-year survival rate with reoperation as the endpoint was 82% (95% CI: 72-99). Radiolucent lines on either the femoral or the tibial side were seen in 36 cases. When comparing the cases that were operated as a primary TKA or as a revision TKA, function, health-related quality of life, and survival were similar. However, after primary TKA the patients generally had less pain and a higher proportion of patients were very satisfied or satisfied.
  
  
  CONCLUSIONS
  Although a high rate of severe complications was observed, most patients improved in function after surgery regardless of whether it was a primary or a revision TKA. We found narrow radiolucent lines-mainly on the tibial side-in nearly half of the cases, but none of the implants were loose radiographically. Overall patient satisfaction and health-related quality of life were high, and a minority had problems with persistent pain.
authors.affiliation: Department of Orthopaedics, Karolinska University Hospital.
authors.forename: Rüdiger J
authors.initials: RJ
authors.lastname: Weiss
authors.forename: Martin
authors.initials: M
authors.lastname: Thorsell
authors.forename: André
authors.initials: A
authors.lastname: Stark
authors.forename: Josefina
authors.initials: J
authors.lastname: Nyvang
authors.forename: Margareta
authors.initials: M
authors.lastname: Hedström
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000209:etiology / Q000401:mortality; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D005500:Follow-Up Studies; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects*; D008875:Middle Aged; D011475:Prosthesis Failure / Q000209:etiology*; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000401:mortality; D012086:Reoperation / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome