Ewald F C, Wright R J, Poss R, Thomas W H, Mason M D, Sledge C B
Department of Orthopaedic Surgery, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
J Arthroplasty. 1999 Jun;14(4):473-80. doi: 10.1016/s0883-5403(99)90104-3.
To understand better the type and incidence of long-term complications in total knee replacement, 306 primary Kinematic total knee arthroplasties performed between June 1978 and December 1982 were prospectively reviewed in detail. The Kinematic knee is a nonconstrained, posterior cruciate-retaining prosthesis that has right and left femoral components to afford anatomic tracking of the patella. The overall revision rate was 6.5%. The most common cause for revision surgery was patellar complications. Ten revisions (3.06%) were for patellar component loosening. Two knees were revised for patella subluxation (0.65%); 1 was in a resurfaced rheumatoid patella, and 1 in an unsurfaced osteoarthritic patella. Stair climbing was better with an unsurfaced patella. Anterior knee pain was 21.8% in the unsurfaced patella and 11.2% in the replaced patella. These data suggest patella replacement is not appropriate with this design.
