Survivorship analysis of 3234 primary knee arthroplasties implanted over a 26-year period (original) (raw)
Related papers
Survivorship analysis of the ”Performance" total knee replacement - 7-year follow-up
International Orthopaedics, 1999
We present the results of a prospective study in which 32 "Performance" total knee replacements were implanted with a mean follow-up period of 6.5 years. Survival analysis showed 89% survival at 7 years. Of those knees that survived to follow-up 80% were pain free or had mild pain when climbing stairs and only 1 knee was unable to flex beyond 100°. Eighty-six percent of patients were able to walk unlimited distances and all knees had a statistically significant improvement in the knee evaluation scores at follow-up. There was no evidence of loosening or migration in the surviving knees.
Open Journal of Orthopedics, 2014
There are several prosthetic knee designs currently in use. There are however very few studies comparing long-term functional outcomes between patients using different models of knee prosthesis in elective knee replacement. In this study, we used the validated Oxford Knee Score (OKS) to retrospectively compare the outcomes of a total of 1635 patients who had an elective total knee replacement in a large District General Hospital, using fifteen different models of knee prosthesis, over a ten-year period. The average scores reported by all patient groups showed significant improvement by three months post-operatively (pre-operative mean score 15.8, post-operative mean score 39.4, p < 0.05), and remained similar for all models of prosthesis used over the total ten-year period. Based on the OKS as an assessment tool, we report no significant difference in long-term functional outcomes for this group of patients following an elective knee replacement, regardless of the type of prosthesis used.
Survival of knee arthroplasties. A nation-wide multicentre investigation of 8000 cases
The journal of bone and joint surgery, 1986
A prospective nationwide study of knee arthroplasty has been under way in Sweden since October 1975. By the end of 1983, 4505 arthroplasties for osteoarthrifis and 3495 for rheumatoid arthritis had been recorded and reviewed one, three and six years after the operation. Using actuarial methods, the probability of the prosthesis remaining in situ after six years was calculated. In osteoarthritis this probabifity ranged from 65% for hinged prostheses to 90% for medial compartment prostheses. Two-and three-compartment prostheses produced intermediate results with 87% survival. In rheumatoid arthritis the probabifity varied from 72% for medial compartment prostheses to 90% for two-and three-compartment prostheses. The main reason for failure was loosening ofthe components, the second most common was infection. The probabifity of revision for infection by six years was 2% in osteoarthritis and 3% in rheumatoid arthritis. Most revisions were to a three-compartment prosthesis. Knee fusion at primary revision was required in 2% of the cases at six years.
Clinical Orthopaedics & Related Research, 2020
Background TKA generally has excellent long-term survivorship. When a new knee system supersedes a previous model, increased survivorship, improved functional performance, or both may be expected, because key areas of design modification are often targeted to address wear, stability, and the patellofemoral articulation. However, not all design changes are beneficial, and to our knowledge, knee arthroplasty has not been systematically evaluated in the context of design changes that occur during the development of new knee arthroplasty systems. Questions/purposes Using the Australian Orthopaedic Association National Joint Replacement Registry Each author certifies that neither he or she, nor any member of his or her immediate family, have funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. Each author certifies that his or her institution approved the reporting of this investigation and that all investigations were conducted in conformity with ethical principles of research.
The Journal of Bone and Joint Surgery
ailure of primary total knee arthroplasty within five years after the operation most frequently occurs because of deep infection (38%), instability (27%), failure of bone ingrowth into a cementless implant (13%), patellar problems (8%), wear (7%), loosening (3%), or miscellaneous problems (4%) 1 . In contrast, in a series of 427 revision total knee arthroplasties, failure of fixation was the most frequent problem, followed by abnormal alignment, component malposition, osseous fracture, and patellar problems 2 . The results of revision total knee arthroplasty are difficult to assess because they are influenced by many factors: the etiology of failure, the extent of bone loss, the quality of the soft tissues, the technique of reconstruction, the adequacy of rehabilitation, patient compliance, the duration of follow-up, and the mode of assessment. Contemporary modular designs have provided good short-term results. A combined review of 161 revisions that had been performed with a modular constrained condylar knee or posterior stabilized design revealed an 80% rate of good or excellent results after an average duration of follow-up of 3.5 years, with a 33% prevalence of radiolucent lines and a 10% rate of complications 3 . The durability of the results will depend in part on the integrity of the locking mechanisms of the modular components, the quality of the polyethylene, and the load transfer conferred by modular stems and augments to the implants. Long-term studies will be necessary to determine if these modular designs are more durable than nonmodular prostheses.
The Journal of Arthroplasty
The results of 57 revision total knee arthroplasties performed for aseptic failure between 1984 and 1992 with a cemented posterior-stabilized or constrained condylar prosthesis were reviewed at follow-up examinations at a minimum of 36 and an average of 62 months (range, 36-120 months). The reason for revision was aseptic loosening of 1 or both components in 32 knees (56%), instability in 16 knees (28%), polyethylene wear and osteolysis in 4 knees (7%), supracondylar femur fracture in 2 knees (4%), and a failed allograft, pain, and arthrofibrosis in 1 knee each (5% total). The average age of the patients at the time of the revision was 74 years (range, 38-90), and the original diagnosis for the majority of patients was osteoarthritis (74%). All of the revision prostheses were cemented posterior stabilized or constrained condylar-type implants. Bone deficiencies were grafted with cancellous allograft in contained defects and cortical allograft in noncontained defects. Five knees were reconstructed with allograft-prosthesis composites. The average modified Hospital for Special Surgery knee score improved from 49 to 82 (100 points possible) at final follow-up evaluation (P < 0.001). Seventy-nine percent of knees were graded as good or excellent. Kaplan-Meier survivorship analysis predicted 94% _+ 6.2 % survival at 40 months and 75% _+ 25% at 99 months. There were 4 clinical failures, 3 of which were related to residual instability in patients with a posterior-stabilized prosthesis. Complications (3 knees) were exclusively related to the extensor mechanism. Radiographically, overall knee alignment improved from 0.3 ° varus to 3.0 ° valgus. Fifty-six percent of tibial components were placed in slight varus alignment. Radiolucent lines occurred in 33% of knees, but there were no complete or progressive radiolucencies. Radiolucent lines were more prevalent adjacent to press-fit intramedullary femoral stems compared with cemented stems (P < .02), but the difference did not correlate with clinical or radiographic failure. The median bone defect score, as proposed by the Knee Society Committee on Bone Defects, was significantly greater in knees that were revisions of a failed cemented total knee arthroplasty compared with revision of a failed cementless total knee arthroplasty (P = .02) but was not correlated with clinical or radiographic outcome (P > .05).
Clinical Orthopaedics and Related Research®, 2014
At 14- to 17-year followup, we reported successful outcomes of the Press-fit Condylar total knee arthroplasty (TKA) system in 160 TKAs performed between 1986 and 1989. However, there are few published reports on TKA survivorship and patient function that include patients evaluated into the third decade after surgery. The study purpose was to determine (1) the survivorship of the implant; and (2) knee function in patients with this TKA system at a mean 20-year followup. We ascertained revision status of all living patients (42 of 160 knees) and all patients (22 knees) who died since the previous study. Among patients alive at the latest followup, Knee Society function scores were obtained and radiographs were evaluated. Kaplan-Meier survivorship analysis with 95% confidence intervals was performed with revision for any reason and aseptic loosening as endpoints. A competing risks analysis with 95% confidence intervals was also performed for revision for any reason as the endpoint. At the mean 20-year (range, 19-25 years) followup, all living patients retained their original implants from the index TKA, exclusive of three polyethylene exchanges. This study demonstrates an 87% Kaplan-Meier survivorship for revision for any reason (95% confidence interval [CI], 80%-92%) and a 98% Kaplan-Meier survivorship for revision for aseptic loosening (95% CI, 93%-99%). Competing risks survivorship was 79% (95% CI, 70%-85%) at 25 years for revision for any reason. Mean Knee Society function score was 46.9. Since the previous study, three revisions have been performed, all for polyethylene wear. The Press-fit Condylar implant system continues to be successful, maintaining longevity up to 25-year followup. This is one of the longest followup studies, reporting continued successes over 20 years, and should serve as a benchmark for current-generation implants. Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Orthopaedics & traumatology, surgery & research : OTSR, 2013
Survivorship for modern total knee arthroplasties (TKA) is not precisely known from large series, other than registries. The present retrospective study therefore analyzed 846 TKAs at a minimum 10 years' follow-up. Ten-year survivorship for TKAs in a multicenter study exceeds 90%, independently of design and level of prosthetic constraint. Eight hundred and twenty-eight patients (846 TKAs) were assessed on the Knee Society score. Mean age was 71 years (range, 41-93 years); 274 males and 554 females (67%); 496 patients (60%) were active; diagnosis was principally osteoarthritis (n=752 [89%]). Most TKAs were cemented (n=704 [83%]), replacing the patella (n=668 [79%]) and sacrificed the posterior cruciate ligament (PCL) (n=707 [84%]), 65% being posterior-stabilized and 35% ultracongruent, with fixed (39%) or mobile bearing (61%). At a minimum 10 years' follow-up, mean knee score rose from 35 (15-55) to 83 points (74-95), and functional score from 24 (5-45) to 74 points (60-90);...
The Results of a Comparison of a Brazilian and an Imported Knee Prosthesis - 5 Years of Follow-Up
Acta Ortopédica Brasileira
Introduction To compare the functional results, satisfaction rates, and revisions of total knee arthroplasties performed by the same surgical team using either Brazilian or imported implants, with a minimum follow-up of 5 years after surgery. Materials and Methods A retrospective cohort study analyzing the medical records and interviews of patients who underwent total knee arthroplasty with Brazilian or imported implants with a minimum of 5 years after surgery. Results One hundred and fifty patients were evaluated (164 knees). In the functional questionnaire, 71% of patients had favorable answers in the group of patients who underwent surgery using the Brazilian prosthesis and 74.8% in the group with imported implants (p=0.634). There was no statistical difference in satisfaction between the groups, with 78.4% of patients satisfied or very satisfied in the Brazilian implant group and 90.7% in the imported implant group (p=0.053). Loosening of the implants was reported in 5.3% versus...