The Journal of Bone and Joint Surgery, Vol 65, Issue 3 293-309, Copyright © 1983 by Journal of Bone and Joint Surgery, Inc
Total knee-replacement arthroplasty. Results with the intramedullary adjustable total knee prosthesis
NS Eftekhar
One hundred and thirty knees (112 patients) in which the intramedullary
adjustable total knee prosthesis was inserted were followed for four to
nine years. This prosthesis is designed to permit unconstrained rotation
and includes a metal tray supporting the high-density-polyethylene tibial
component as well as an intramedullary stem and two condylar intramedullary
projections on both the femoral component and the tibial component. Using a
rating system in which pain, function, stability, and motion each was
graded independently on a scale of 1 to 6, the preoperative scores were 73
per cent poor and 27 per cent fair, while the postoperative scores were 77
per cent good, 15 per cent fair, and 8 per cent poor. If only the patients
with unilateral or bilateral involvement of the knee without other
functional disabilities were considered, four to nine years after the
arthroplasty 92 per cent could be classified as good; 5 per cent, as fair;
and 3 per cent, as poor. There were two deaths (one due to pulmonary
embolism and the other, to overwhelming sepsis after attempted arthrodesis
for a deep would infection) and five deep infections, four of which
necessitated reoperation for arthrodesis. In addition, reoperations were
necessary in five other knees: in two for secondary closure of the wound,
in one for evacuation of a hematoma, in one for synovectomy and
skin-grafting because of infection, and in one for recentralization of the
patella. At final evaluation, 117 knees had radiographs of sufficiently
good quality for assessment, and thirty-seven (32 per cent) of these showed
evidence of a nonprogressive radiolucent line about the tibial component.
In addition, two were considered clinically loose (one due to a traumatic
injury and the other, to malpositioning of the tibial component).
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