Prospective analysis of Sheehan total knee arthroplasty.

In a prospective study, the clinical results of 64 Sheehan total knee arthroplasties (TKA) were reviewed in 52 patients, with an average follow-up period of five and one-half years. Like most prosthetic designs in use in 1975, the Sheehan prosthesis did not incorporate patellar resurfacing. The initial clinical success achieved without patello-femoral replacement may become less acceptable with longer follow-up periods. Seventy-four percent of the patients in this study had complete relief of pain or mild discomfort not requiring analgesics. With patellar resurfacing as a secondary procedure in three additional cases, the percent successful results increased to 81%. Five knees (12%) required additional surgery, one because of infection, two because of secondary component failure, and two for loosening. The lack of patellofemoral replacement and prospective failure of both tibial and femoral components, possibly due to high stress-loading in a relatively small surface area, have led to the use of other newer TKA designs.