GUEPAR total knee prosthesis. Results and outcome of seven years' use in a district general hospital.

Between 1980 and 1987, 44 total knee arthroplasties of the GUEPAR type were performed in 38 patients with severe degenerative joint disease. The patients have been followed up for 7 years and 70% of cases had a good or fair result. The 13 poor results included five cases of deep sepsis, three of whom subsequently underwent successful arthrodesis at this hospital. Other causes of a poor outcome were loosening and patellofemoral dysfunction. Radiological review of 27 knees showed that 80% had lucent lines at either cement/prosthesis or bone/cement interface, although these radiological findings were not associated with clinical evidence of loosening. The major long-term complication was shown to be retropatellar pain, which was recognized in 16% of all cases. However, this would seem to be the only significant long-term complication, and we believe that with the use of a patellar button the GUEPAR prosthesis should continue to be used in selected cases of severe degenerative joint disease.