Survivorship analysis of cementless meniscal bearing total knee arthroplasty.

Four hundred seventy-three consecutive cementless cruciate retaining meniscal bearing primary total knee replacements were done on 375 patients from May 1985 to February 1991. These were observed for a 10-year period (average, 5 years). Seventeen (3.6%) required change of components because of mechanical failure. There were 12 polyethylene fractures or dislocations. There were 5 tibial subluxations secondary to ligamentous instability occurring at an average of 21 months postoperatively. There were 2 component loosenings secondary to bone graft resorption (1 femoral, 1 tibial). There were 5 infections (4 Staphylococcus aureus, 1 Pseudomonas). Significantly, with the exception of the 2 knees with bone graft resorption, there was no component (femoral, tibial, or patellar) loosening. Kaplan-Meier survival estimates, using as an endpoint of revision surgery for any mechanical reason (polyethylene breakage, polyethylene dislocation, or ligamentous instability), showed a survivorship of 94.6% at the 8-year interval. Survivorship related to mechanical loosening of fixation of any component at the 8-year interval was 99%.

Early flexion routine. An alternative method of continuous passive motion.

One hundred knees that underwent primary total knee arthroplasties were divided into 2 groups: the first 50 consecutive knees were assigned retrospectively to Group I (control), and the following 50 knees were assigned prospectively to Group II (early flexion). All procedures were cementless meniscal-bearing total knee arthroplasties and were performed by the same surgeon. Maximum early flexion (Group II) resulted in decreased length of stay, decreased hospital costs, and increased range of motion at 1 year. In light of current government interest in hospital cost reduction, this method should be considered as an attractive alternative to continuous passive motion.