The Journal of Bone and Joint Surgery, Vol 70, Issue 4 483-490, Copyright © 1988 by Journal of Bone and Joint Surgery, Inc
The cemented kinematic-II and the non-cemented porous-coated anatomic prostheses for total knee replacement. A prospective evaluation
CH Rorabeck, RB Bourne and L Nott
Division of Orthopaedic Surgery, University Hospital, London, Ontario.
One hundred and sixty consecutive total knee arthroplasties were performed
in 143 patients: 110 procedures, with a cemented kinematic-II prosthesis
and fifty procedures, with a non-cemented porous-coated anatomic
prosthesis. Each patient was evaluated before the operation and six weeks
and three, six, twelve, and twenty-four months postoperatively. At a
minimum twenty-four-month follow-up, the average Hospital for Special
Surgery knee-rating score for the patients who had a cemented kinematic-II
prosthesis was 9 points higher than the average score for the patients who
had a non-cemented anatomic implant (88 points and 79 points). At the same
follow-up period, the maximum flexion of the knees that had a cemented
kinematic-II prosthesis was greater than that of the knees that had a
non-cemented anatomic prosthesis (106 degrees and 97 degrees). In addition,
the rate of reoperation for the patients who had a cemented kinematic-II
replacement was 4 per cent, compared with 12 per cent for the patients who
had a non-cemented anatomic prosthesis. On the basis of this prospective,
non-randomized clinical review of unselected patients, we concluded that
the results with the cemented kinematic-II prosthesis were superior to
those with the non-cemented anatomic prosthesis at a minimum twenty-four
month follow-up; however, these superior results may be related to the use
of cement or to differences in the designs of the prostheses, the ages of
the patients, or the postoperative management of the two groups of
patients.
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