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10-YEAR RESULTS OF A HYDROXYAPATITE COATED INSALL-BURNSTEIN II TOTAL KNEE REPLACEMENT



Abstract

We have prospectively followed 100 consecutive HA coated knee replacements performed from 1990–1992. The prostheses was a cruciate sacrificing IB II, with HA coating on the femoral and tibial components. The average age at surgery was 72.5 years [32–92]. The indications for surgery was predominantly osteoarthritis [93 cases]. 3 knees required cemented tibial components at surgery and were excluded from the series. All knees were mobilised full weight bearing postoperatively.

Patients were reviewed annually with radiographic and clinical evaluation [Hospital for Special Surgery Knee score]. There was no loss to follow-up and at most recent review 48 people [60 knees] were alive. Of these, 47 knees had a final radiographic examination; the remaining knees were assessed clinically but did not attend hospital.

Using revision or need for revision as the endpoint for failure, 6 knees have been revised giving a 10 year survival of 92% [CI 0.96–0.76]. 3 tibial and 2 femoral components underwent aseptic loosening. 1 revision was for infection and 1 for technical errors.

Using pain as the endpoint for survival, 5 surviving knees [9.3%] complained of moderate or severe pain at rest or during exercise and could be regarded as failures.

There is a very low incidence of radiolucent lines at the prostheses-bone interface with 11 radiolucent zones of < 1mm under the tibial component [knee society radiological evaluation]. 72% of cases demonstrated evidence of bone-prostheses bonding with ‘spot welds’ or buttress formation.

Overall the survival at ten years is comparable with cemented fixation. We believe the evidence of bone-prostheses bonding and absence of radiolucent lines indicates that the surviving knees will continue to function well.

The abstracts were prepared by Mr Richard Buxton. Correspondence should be addressed to him at Bankton Cottage, 21 Bankton Park, Kingskettle, Cupar, Fife KY15 7PY, United Kingdom