Cemented fixed-bearing PFC total knee arthroplasty: survival and failure analysis at 12–17?years

摘要

class="Heading">Background class="Para">Total knee arthroplasty (TKA) is the appropriate treatment for degenerative pathology of the knee. Implant surveillance is mandatory to improve clinical results. We present the long-term results of a series of consecutive TKA Press Fit Condylar (J&J), cemented fixed bearing with selective patellar resurfacing in nonselected patients. class="Heading">Materials and methods class="Para">In this prospective case series, 223 TKA were clinically and radiographically evaluated using the Hospital for Special Surgery (HSS) knee score and the Knee Society Roentgenographic Evaluation and Scoring System. class="Heading">Results class="Para">There were 197 patients, with an average age of 68.4?years [95% confidence interval (CI) 52.7–84.1?years]; 49 arthroplasties were implanted in men (21.1%) and 184 (78.9%) in women. The average follow-up was approximately 13.5?years (162.1?months; 95% CI 132.3–191.9), and it was possible to evaluate 179 implants (76.8% of the implanted prosthesis) in 176 patients. The average HSS score increased from 61.5 (95% CI 60.4–62.7) to 89.4 (95% CI 87.7–.93.5) points. The cumulative average survival rate at 15?years (the endpoint being failure with revision) was 90.6% ?±?2% standard deviation. Resurfacing the patella did not make a difference in terms of implant survival. Progressive radiolucent lines were observed around 20 implants (14.3%); all were revised. class="Heading">Conclusions class="Para">The PFC system is an excellent prosthetic solution. Early clinical complications, mechanical axis and patellar resurfacing do not correlate with implant failure, whereas progressive radiolucent lines do.