Skip to main content

Advertisement

SpringerLink
Log in

International multi-centre survivorship analysis of mobile bearing total knee arthroplasty

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

We retrospectively reviewed the experience of a large international multi-centre study of primary total knee arthroplasty with mobile bearing design and modifications of the tibial component to allow for bicruciate preservation, posterior cruciate retention, or sacrifice. Twenty-seven surgeons performed 4,743 total knee replacements between 1981 and 1997. Implants inserted were 324 that retained both cruciate ligaments, 2,165 that retained the posterior cruciate, and 2,254 that sacrificed both cruciates. The patella was resurfaced in 2,838 and unresurfaced in 1,905. With failure defined as revision or reoperation for any reason, the overall survivorship was 79% at 16 years’ follow-up. Revision occurred in 259 (5.4%) knees out of the entire cohort. The risk adjusted rates of failure were higher in females, younger patients, osteoarthritis, post-traumatic arthritis, and in patients who had a meniscal bearing prosthesis or patellar resurfacing. The most common cause of revision was bearing-related issues including chronic instability, bearing subluxation, bearing dislocation, or bearing wear in 2.3%.

Résumé

Nous avons revu rétrospectivement une série multicentrique de prothèses totales primaires de genoux avec plateaux mobiles et pièce tibiale permettant le sacrifice ou la conservation d’un ou des deux ligaments croisés. Entre 1981 et 1997, 4743 prothèses ont été faite par 27 chirugiens. Les implants utilisés étaient pour 2254 sans ligaments croisés, pour 2165 avec croisé postérieur et pour 324 avec conservation des 2 croisés. La rotule a été resurfacée 2838 fois. Avec l’échec défini par la reprise chirurgicale, la survie était de 79% à 16 ans de recul. Une reprise a été faite 259 fois (5,4%). Le risque d’échec était plus grand chez les femmes, les patients jeunes, en cas d’arthrose primaire ou post traumatique et chez les patients avec une prothèse à ménisques mobiles ou avec une rotule prothèsée. Les causes les plus fréquentes de révision étaient l’instabilité chronique, la subluxation ou la luxation des plateaux mobiles et leur usure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Argenson J-N, O’Connor JJ (1992) Polyethylene wear in meniscal knee replacement. A one to nine-year retrieval analysis of the Oxford knee. J Bone Joint Surg 74-B:228–232

    Google Scholar 

  2. Bartel DL, Bicknell VL, Wright TM (1986) The effect of conformity, thickness, and material on stresses in ultra-high molecular weight components for total joint replacement. J Bone Joint Surg 68-A:1041–1051

    Google Scholar 

  3. Bayley JC, Scott RD, Ewald FC, Holmes GB (1988) Failure of the metal-backed patellar component after total knee replacement. J Bone Joint Surg 70A:668–674

    Google Scholar 

  4. Becker MW, Insall JN, Faris PM (1991) Bilateral total knee arthropalsty. One cruciate retaining and once cruciate substituting. Clin Orthop 271:122–124

    PubMed  Google Scholar 

  5. Berger RA, Rosenberg AG, Barden RM, Sheinkop MB, Jacobs JJ, Galante JO (2001) Long-term followup of the Miller-Galante total knee replacement. Clin Orthop 388:58–67

    Article  PubMed  Google Scholar 

  6. Bert JM (1990) Dislocation/subluxation of meniscal bearing elements after New Jersey low-contact stress total knee arthroplasty. Clin Orthop 254:211–215

    PubMed  Google Scholar 

  7. Buechel FF, Pappas MJ (1986) The New Jersey low-contact-stress knee replacement system: biomechanical rationale and review of the first 123 cemented cases. Arch Orthop Trauma Surg 105:197–204

    Article  PubMed  CAS  Google Scholar 

  8. Buechel FF, Pappas MJ (1989) New Jersey low contact stress knee replacement system. Ten-year evaluation of meniscal bearings. Orthop Clin North Am 20:147–177

    PubMed  CAS  Google Scholar 

  9. Buechel FF, Pappas MJ (1990) Long-term survivorship analysis of cruciate-sparing versus cruciate-sacrificing knee prostheses using meniscal bearings. Clin Orthop 260:162–169

    PubMed  Google Scholar 

  10. Buechel FF, Rosa RA, Pappas MJ (1989) A metal-backed, rotating-bearing patellar prosthesis to lower contact stress. An 11-year clinical study. Clin Orthop 248:34–49

    PubMed  Google Scholar 

  11. Buechel FF Sr, Buechel FF Jr, Pappas MJ, D’Alessio J (2000) Twenty-year evaluation of meniscal bearing and rotating platform knee replacements. Clin Orthop 388:41–50

    Google Scholar 

  12. Buechel Sr FF, Buechel Jr FF, Pappas MJ, D’Alessio J (2002) Twenty-year evaluation of the New Jersey LCS rotating platform knee replacement. J Knee Surg 15:84–89

    PubMed  Google Scholar 

  13. Callaghan JJ, Squire MW, Goetz DD et al (2000) Cemented rotating-platform total knee replacement. J Bone Joint Surg 82A:705–711

    Google Scholar 

  14. Callahan CM, Drake BG, Heck DA, Dittus RS (1994) Patient outcomes following tricompartmental total knee replacement. A meta-analysis. J Am Med Assoc 271:1349–1357

    Article  CAS  Google Scholar 

  15. Colizza WA, Insall JA, Scuderi GR (1995) The posterior stabilized total knee prosthesis. Assessment of polyethylene damage and osteolysis after a ten-year-minimum follow-up. J Bone Joint Surg 77-A:1713–1720

    Google Scholar 

  16. Collier JP, Mayor MB, McNamara JL, Surprenant VA, Jensen RE (1991) Analysis of the failure of 122 polyethylene inserts from uncemented tibial knee components. Clin Orthop 273:232–242

    PubMed  Google Scholar 

  17. Dennis DA, Clayton ML, O’Donnell S, Mack RP, Stringer EA (1999) Posterior cruciate condylar total knee arthroplasty. Average 11-year follow-up evaluation. Clin Orthop 281:168–176

    Google Scholar 

  18. Dorey F, Amstutz HC (1986) Survivorship analysis in total joint arthroplasty. J Arthroplasty 1:63–69

    Article  PubMed  CAS  Google Scholar 

  19. Dorr LD, Ochsner JL, Gronley J, Perry J (1988) Functional comparison of posterior cruciate-retained versus cruciate-sacrificed total knee arthroplasty. Clin Orthop 236:36–43

    PubMed  Google Scholar 

  20. Engh GA (1988) Failure of the polyethylene bearing surface of a total knee replacement within four years. A case report. J Bone Joint Surg 70-A:1093–1096

    Google Scholar 

  21. Engh GA, Dwyer, KA, Hanes CK (1992) Polyethylene wear of metal-backed tibial components in total and unicompartmental knee prostheses. J Bone Joint Surg 74-B:9–17

    Google Scholar 

  22. Ewald FC, Wright RJ, Poss R, Thomas WH, Mason MD, Sledge CB (1999) Kinematic total knee arthroplasty: a 10- to 14-year prospective follow-up- review. J Arthroplasty 14:473–480

    Article  PubMed  CAS  Google Scholar 

  23. Ezzet KA, Garcia R, Barrack RL (1995) Effect of component fixation method on osteolysis in total knee arthroplasty. Clin Orthop 321:86–91

    PubMed  Google Scholar 

  24. Figgie HE III, Goldberg VM, Inglis AE, Kelly M, Sobel M (1989) The effect of alignment of the implant on fractures of the patella after condylar total knee arthroplasty. J Bone Joint Surg 71A:1031–1039

    Google Scholar 

  25. Font-Rodriguez DE, Scuderi GR, Insall JN (1997) Survivorship of cemented total knee arthroplasty. Clin Orthop 345:79–86

    PubMed  Google Scholar 

  26. Goodfellow J, O’Connor JJ (1978) The mechanics of the knee and prosthesis design. J Bone and Joint Surg 60-B:358–362

    CAS  Google Scholar 

  27. Goodfellow JW, O’Connor JJ (1986) Clinical results of the Oxford knee. Surface arthroplasty of the tibiofemoral joint with a meniscal bearing prosthesis. Clin Orthop 205:21–42

    PubMed  Google Scholar 

  28. Insall JN, Ranawat CS, Aglietti P, Shine J (1976) A comparison of four models of total knee-replacement prostheses. J Bone Joint Surg 58-A:754–765

    Google Scholar 

  29. Jordan LR, Olivo JL, Voorhorst PE (1997) Survivorship analysis of cementless meniscal bearing total knee arthroplasty. Clin Orthop Relat Res 338:119–123

    Article  PubMed  Google Scholar 

  30. Keblish PA, Varma AK, Greenwald AS (1994) Patellar resurfacing or retention in total knee arthroplasty. A prospective study of patients with bilateral replacements. J Bone Joint Surg 76B:930–937

    Google Scholar 

  31. Laskin RS (2001) The Genesis total knee prosthesis. Clin Orthop 388:95–102

    Article  PubMed  Google Scholar 

  32. Lombardi AV, Engh GA, Volz RG, Albrigo JL, Brainard BJ (1988) Fracture/dislocation of the polyethylene in metal-backed patellar components in total knee arthroplasty. J Bone Joint Surg 70A:675–679

    Google Scholar 

  33. MacCollum MS, Karpman RR (1989) Complications of the PCA anatomic patella. Orthopaedics 12:1423–1428

    Google Scholar 

  34. McNamara JL, Collier JP, Mayor MB, Jensen RE (1994) A comparison of contact pressures in tibial and patellar total knee components before and after service in vivo. Clin Orthop 299:104–113

    PubMed  Google Scholar 

  35. Malkani AL, Rand JA, Bryan RS, Wallrichs SL (1995) Total knee arthroplasty with the kinematics condylar prosthesis. A ten-year follow-up study. J Bone Joint Surg 77-A:423–431

    Google Scholar 

  36. O’Connor JJ, Goodfellow JW (1996) Theory and practice of meniscal knee replacement: designing against wear. Proc Inst Mech Eng [H] 210:217–222

    CAS  Google Scholar 

  37. Parks NL, Engh GA, Topoleski LD, Emperado J (1998) Modular tibial insert micromotion. A concern with contemporary knee implants. Clin Orthop 356:10–15

    Article  PubMed  Google Scholar 

  38. Pavone V, Boettner F, Fickert S, Sculco TP (2001) Total condylar arthroplasty. A long-term follow-up. Clin Orthop 388:18–25

    Article  PubMed  Google Scholar 

  39. Ranawat CS, Boachie-Adjei O (1988) Survivorship analysis and results of total condylar knee arthroplasty. Eight- to 11-year follow-up period. Clin Orthop 226:6–13

    PubMed  Google Scholar 

  40. Ranawat CS, Flynn WF Jr, Deshmukh RG (1994) Impact of modern technique on long-term results of total condylar knee arthroplasty. Clin Orthop 309:131–135

    PubMed  Google Scholar 

  41. Rand JA, Ilstrup DM (1991) Survivorship analysis of total knee arthroplasty. Cumulative rates of survival of 9200 total knee arthroplasties. J Bone Joint Surg 73-A:397–409

    Google Scholar 

  42. Ritter MA, Campbell E, Faris PM, Keating EM (1989) Long-term survival analysis of the posterior cruciate condylar total knee arthroplasty. A 10-year evaluation. J Arthroplasty 4:293–296

    Article  PubMed  CAS  Google Scholar 

  43. Ritter MA, Berend ME, Meding JB, Keating EM, Faris PM, Crites BM (2001) Long-term followup of anatomic graduated components posterior cruciate-retaining total knee replacement. Clin Orthop 388:51–57

    Article  PubMed  Google Scholar 

  44. Robertsson O, Knutson K, Lewold S, Lidgren L (2001) The Swedish knee arthroplasty register 1975-1997: an update with special emphasis on 41223 knees operated on in 1988–1997. Acta Orthop Scand 72:503–513

    Article  PubMed  CAS  Google Scholar 

  45. Rodriguez JA, Bhende H, Ranawat CS (2001) Total condylar replacement. A 20-year followup study. Clin Orthop 388:10–17

    Article  PubMed  Google Scholar 

  46. Rosenberg AG, Andriacchi TP, Barden R, Galante JO (1988) Patellar component failure in cementless total knee arthroplasty. Clin Orthop 236:106–114

    PubMed  Google Scholar 

  47. Sánchez-Sotelo J, Ordonez JM, Prats SB (1999) Results and complications of the low contact stress knee prosthesis. J Arthroplasty 14:815–821

    Article  PubMed  Google Scholar 

  48. Schai PA, Thornhill TS, Scott RD (1998) Total knee arthroplasty with the PFC system. Results at a minimum of ten years and survivorship analysis. J Bone Joint Surg 80-B:850–858

    Article  Google Scholar 

  49. Scott RD, Volatile TB (1986) Twelve years’ experience with posterior cruciate-retaining total knee arthroplasty. Clin Orthop 205:100–107

    PubMed  Google Scholar 

  50. Scott WN, Rubinstein M, Scuderi G (1988) Results after knee replacement with a posterior cruciate-substituting prosthesis. J Bone Joint Surg 70-A:1163–1173

    Google Scholar 

  51. Scuderi GR, Insall JN, Windsor RE, Moran MC (1989) Survivorship of cemented knee replacements. J Bone Joint Surg 71-B:798–804

    Google Scholar 

  52. Sextro GS, Berry DJ, Rand JA (2001) Total knee arthroplasty using cruciate-retaining kinematic condylar prosthesis. Clin Orthop 388:33–40

    Article  PubMed  Google Scholar 

  53. Shoji H, Wolf A, Packard S, Yoshino S (1994) Cruciate retained and excised total knee arthroplasty. A coparative study in patients with bilateral total knee arthroplasty. Clin Orthop 205:218–222

    Google Scholar 

  54. Sorrells RB (1996) Primary knee arthroplasty: long-term outcomes. The rotating platform mobile bearing TKA. Orthopedics 19:793–796

    PubMed  CAS  Google Scholar 

  55. Stern SH, Insall JN (1992) Posterior stabilized prosthesis. Results after follow-up of nine to twelve years. J Bone Joint Surg 74-A:980–986

    Google Scholar 

  56. Vince KG, Insall JN, Kelly MA (1989) The total condylar prosthesis. 10- to 12-year results of a cemented knee replacement. J Bone Joint Surg 71-B:793–797

    Google Scholar 

  57. Wasielewski RC, Parks N, Williams I, Surprenant H, Collier JP, Engh G (1997) Tibial insert undersurface as a contributing source of polyethylene wear debris. Clin Orthop 345:53–59

    PubMed  Google Scholar 

  58. Weaver JK, Derkash RS, Greenwald SD (1993) Difficulties with bearing dislocation and breakage using a movable bearing total knee replacement system. Clin Orthop 290:244–252

    PubMed  Google Scholar 

  59. Whiteside LA (1995) Effect of porous-coating configuration on tibial osteolysis after total knee arthroplasty. Clin Orthop 321:92–97

    PubMed  Google Scholar 

  60. Whiteside LA (2001) Long-term followup of the bone-ingrowth Ortholoc knee system without a metal-backed patella. Clin Orthop 388:77–84

    Article  PubMed  Google Scholar 

  61. Wright TM, Bartel DL (1986) The problem of surface damage in polyethylene total knee components. Clin Orthop 205:67–74

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Columbia St Mary’s Hospital, Milwaukee, WI, USA

    James B. Stiehl

  2. Slotevaart Hospital, Amsterdam, The Netherlands

    Karel J. Hamelynck

  3. 700 Orthopaedic Drive, Warsaw, IN, USA

    Paul E. Voorhorst

  4. 575 W River Woods Parkway, #204, Milwaukee, WI, 53212, USA

    James B. Stiehl

Authors
  1. James B. Stiehl
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Karel J. Hamelynck
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paul E. Voorhorst
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to James B. Stiehl.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stiehl, J.B., Hamelynck, K.J. & Voorhorst, P.E. International multi-centre survivorship analysis of mobile bearing total knee arthroplasty. International Orthopaedics (SICO 30, 190–199 (2006). https://doi.org/10.1007/s00264-005-0053-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-005-0053-z

Keywords

Search

Navigation