The Journal of Bone and Joint Surgery 82:705 (2000)
© 2000 The Journal of Bone and Joint Surgery, Inc.
Cemented Rotating-Platform Total Knee Replacement
A Nine to Twelve-Year Follow-up Study*
John J. Callaghan, M.D. ,
Matt W. Squire, M.D.,
Devon D. Goetz, M.D. ,
Patrick M. Sullivan, M.D. and
Richard C. Johnston, M.D.
Investigation performed at Iowa Methodist Hospital, Des Moines,
and University of Iowa College of Medicine, Iowa City, Iowa
*One or more of the authors has received or will receive benefits
for personal or professional use from a commercial party related
directly or indirectly to the subject of this article. In addition,
benefits have been or will be directed to a research fund, foundation,
educational institution, or other nonprofit organization with which
one or more of the authors is associated. No funds were received in
support of this study.
Department of Orthopaedic Surgery, University of Iowa Hospitals
and Clinics, 200 Hawkins Drive, Iowa City, Iowa 52242-1088. Please
address requests for reprints to J. J. Callaghan. E-mail address
for J. J. Callaghan: john-callaghan{at}uiowa.edu
Des Moines Orthopaedics, 6001 Westown Parkway, West Des Moines,
Iowa 50266-7702.
Background: Although the LCS (low contact
stress) rotating-platform mobile-bearing knee replacement has been
used extensively, there have been few intermediate or long-term
clinical and radiographic follow-up studies evaluating the device.
The purpose of this study was to report the nine to twelve-year results
of a consecutive series of patients who had a primary total knee
replacement performed with this device.
Methods: Between November 1985 and November
1988, the senior author (R. C. J.) performed 119 consecutive total
knee arthroplasties in eighty-six patients with LCS rotating-platform
femoral and tibial components and a Townley all-polyethylene dome
patellar component. All components were fixed with cement. The average
age of the patients at the time of the operation was seventy years (range,
thirty-seven to eighty-eight years). Fifty-two patients (seventy-six
knees) were female, and thirty-four patients (forty-three knees)
were male. The patients were evaluated with clinical knee ratings
and radiographic analysis nine to twelve years following the knee
replacement.
Results: At the time of the nine to twelve-year
follow-up, sixty-four patients (eighty-six knees) were alive, eighteen
patients (twenty-eight knees) had died, and four patients (five
knees) had been lost to follow-up. Of the 114 knees in the eighty-two
patients for whom the final outcome was known, none required a reoperation
and none had a dislocation of the mobile-bearing prosthesis. For
the forty-five patients (sixty-six knees) who returned for final
clinical and radiographic follow-up examinations at nine to twelve
years, the average clinical and functional Knee Society ratings
were 30 points (range, 2 to 70 points) and 44 points (range, 0 to
80 points) preoperatively and 90 points (range, 63 to 102 points)
and 75 points (range, 30 to 100 points) at the final follow-up evaluation. The
average Hospital for Special Surgery knee rating was 57 points (range,
28 to 80 points) preoperatively and 84 points (range, 59 to 97 points)
at the final follow-up evaluation. The average active range of knee
flexion was from 0 degrees (range, 0 to 10 degrees) to 102 degrees
(range, 15 to 120 degrees) at the final follow-up evaluation. Seven
of the sixty-six knees were painful anteriorly. There was no periprosthetic
osteolysis and no evidence of loosening on follow-up radiographs.
Conclusions: After nine to twelve years of follow-up,
the cemented LCS rotating-platform knee replacement was found to
be performing well, with durable clinical and radiographic results.
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