Skip to main content

Advertisement

Log in

Total knee arthroplasty with retention of both cruciate ligaments. A 9 to 11 year follow-up study

  • Original articles
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

This is a prospective assessment of 163 total knee arthroplasties in 130 patients with the retention of both cruciate ligaments of which 107 knees in 89 patients have been followed for ten years. The patients were 34 men and 96 women whose average age, at the time of the index arthroplasty, was 67 years (range: 40 to 84 years). The diagnosis was osteoarthritis in 122 (75%) knees and rheumatoid arthritis in 41 (25%). Twenty-six knees had a valgus deformity, 109 knees a varus deformity and 28 knees had a normal alignment of 5 to 10° of valgus. The anterior cruciate ligament was relatively normal in 96 knees and partly degenerated in 67 knees. Using the Knee Society rating system (37), all 163 knees were prospectively evaluated at yearly intervals including 56 knees in 41 patients who were followed in this manner until they died or were lost to follow-up. 104 knees (97%) of the 107 knees available for study at ten years had excellent or good results. At the latest follow-up in this group of patients, pain was adequately relieved in 97 knees (91%), the average flexion range was 107 ± 12.6° (range: 65 to 135°). Ninety-five knees (89%) had normal antero-posterior stability (less than 5 mm) and 12 knees (11%) had (5 to 10 mm) as determined by the drawer sign. Ninety-six knees (90%) had normal mediolateral stability and 11 knees (10%) had a laxity from 5 to 10°. Ninety-four knees (88%) had a valgus alignment of 5 to 10°. The average knee score was 90.7 ± 8.4 (range: 54 to 100) and the functional score was 82 ± 21 (range: 10 to 100). The survival at ten years with the end point being revision was 94.8% ± 1.95. Seven knees (4.3%) of the 163 knees in this series were revised. There were no revision for patellar problems or aseptic tibial component loosening. The good anteroposterior stability at latest follow-up in this series indicates that both the anterior and posterior cruciate ligaments, even when partly degenerated, remain functional after an average follow-up of ten years.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Andriacchi T (1981) In vivo evaluation of patient function following total knee replacement. Orthop Trans 5: 416

    Google Scholar 

  2. Andriacchi TP, Galante JO, Fermier RW (1982) The influence of the total knee-replacement design on walking and stair-climbing. J Bone Joint Surg 64-A: 1328–1335

    Google Scholar 

  3. Cloutier JM, Gauthier F (1976) Arthroplastie du genou (prothèse Marmor). Union Med Canada 105: 900–902

    Google Scholar 

  4. Cloutier JM (1983) Results of the total knee arthroplasty with a non-constrained prosthesis. J Bone Jone Surg 64-A: 906–919

    Google Scholar 

  5. Cloutier JM (1991) Long term results after non-constrained total knee arthroplasty. Clin Orthop 273: 63–65

    Google Scholar 

  6. Colliza WA, Insall JN, Scuderi GR (1995) The posterior stabilized total knee prosthesis: Assessment of polyethylene damage and osteolysis after a ten year minimum follow-up. J Bone Joint Surg 77-A: 1713–1720

    Google Scholar 

  7. Dennis DA, Komisek RD, Calwell CW, Scott RD, Thomas T, Ranawat CS (1997) In vivo anteroposterior femoro-tibial translations: A multicentric analysis. Interim Meeting of the Knee Society, New York, 4–5 sept.

    Google Scholar 

  8. Engh GA, Dwyer KA, Hanes CK (1992) Polyethylene wear of metal back tibial components in total and unicompartimental knee prostheses. J Bone Joint Surg 74-B: 9–17

    Google Scholar 

  9. Ewald FC (1989) The knee society total knee arthroplasty evaluation and scoring system. Clin Orthop 248: 9–12

    Google Scholar 

  10. Feng EL, Stueberg SD, Wixson RL (1994) Progressive subluxation and polyethylene wear in total knee replacement with flat articular surface. Clin Orthop 299: 60–71

    Google Scholar 

  11. Freeman MAR, Sculco T, Todd RC (1997) Replacement of the severly damaged knee by the ICLH (Freeman Swanson) arthroplasty. J Bone Joint Surg 59-B: 64–71

    Google Scholar 

  12. Goodfellow J, O'Connor J (1978) The mechanics of the knee and prosthesis design. J Bone Joint Surg 60-B: 358–369

    Google Scholar 

  13. Gunston FH (1971) Polycentric knee arthroplasty. Prosthetic simulation of normal knee movement. J Bone Joint Surg 53-B: 272–277

    Google Scholar 

  14. Gunston FH, MacKenzie RI (1976) Complications of polycentric knee arthroplasty. Clin Orthop 120: 11–17

    Google Scholar 

  15. Insall JN, Dorr LD, Scott WN (1989) Rationale of the knee society clinical rating system. Clin Orthop 248: 13–14

    Google Scholar 

  16. Komistek RD (1997) Personal communication, Dec 19

  17. Lew WD, Lewis JL (1982) The effect of knee prosthesis geometry on cruciate ligaments mechanics during fkexion. J Bone Joint Surg 64-A: 734–739

    Google Scholar 

  18. Lewis P, Rorabeck CH, Bourne RB, Devane P (1994) Posteromedial tibial polyethylene failure in total knee replacements. Clin Orthop 299: 11–17

    Google Scholar 

  19. Lindstrand A, Stenstrom A, Lewold S (1992) Multicenter study of unicompartmental knee revision: PCA, Marmor, and St-George compared in 3777 cases of arthrosis. Acta Orthop Scand 63: 256–259

    Google Scholar 

  20. Malkani AL, Rand JA, Bryan RS (1995) Total knee arthroplasty with the kinematic condylar prosthesis: A ten-year follow-up study. J Bone Joint Surg 77-A: 423–431

    Google Scholar 

  21. Mallory TH, Smalley D, Danyi J (1982) Townley anatomic total knee arthropalsty using total tibial component with cruciate release. Clin Orthop 169: 197–201

    Google Scholar 

  22. Marmor L (1993) Unicompartimental arthroplasty for osteonecrosis of the knee joint. Clin Orthop 294: 247–253

    Google Scholar 

  23. Nafei A, Kristensen O, Knudsen HM, Jensen J (1996) Survivorship analysis of cemented total condylar knee arthroplasty. J Arthroplasty 11: 7–10

    Google Scholar 

  24. Nelissen RGHH, Brand R, Rozing PM (1992) Survivorship analysis in total condylar knee arthroplasty. A statical review. J Bone Joint Surg 74-A: 388–389

    Google Scholar 

  25. Nieto JF, Coresh J (1996) Adjusting survival curves for cofouders. A review and a new method. Am J of Epidemiology 143: 1059–1068

    Google Scholar 

  26. Pritchett JW (1993) Anterior cruciate retaining total knee arthroplasty. A 15 year survivorship study. Clin Orthop 286: 96–102

    Google Scholar 

  27. Ranawat CS, Flynn WF, Saddler S, Hansraj KK, Maynard MJ (1993) Long-term results of the total condylar knee arthroplasty. A 15 year survivorship study. Clin Orthop 286: 94–102

    Google Scholar 

  28. Ritter MA, Campbell E, Faris PM, Keating EM (1989) Long-term survival analysis of the posterior cruciate condylar total knee arthroplasty. A 10-year evaluation. J Arthroplasty 4: 293–296

    Google Scholar 

  29. Rodriguez JA, Saddler S, Edelman A, Ranawat CS (1996) Long-term results of total knee arthroplasty in cases 3 and 4 reumatoid arthritis. J Arthroplasty 11: 141–145

    Google Scholar 

  30. Rorabeck CH, Bourne RB, Lewis PL, Nott L (1993) The Miller-Galante knee prosthesis for the treatment of osteonecrosis. A comparison of the results of the partial fixation with cement and fixation without any cement. J Bone Joint Surg 75-A: 402–408

    Google Scholar 

  31. Skolnick MD, Coventry MB, Ilstrup DM (1976) Geometric total knee arthroplasty. A two-year follow-up study. J Bone Joint Surg 58-A: 749–753

    Google Scholar 

  32. Sledge CB, Ewald FC (1979) Total knee arthroplasty experience at the Robert Breck Brigham Hospital. Clin Orthop 145: 78–84

    Google Scholar 

  33. Townley CO (1988) Total knee arthroplasty. A personal retrospective and prospective review. Clin Orthop 236: 8–22

    Google Scholar 

  34. Walker PS, Green D, Reilly D, Thatcher J, Ben Dov M, Ewald FC (1981) Fixation of the tibial components of the knee prosthesis. J Bone Joint Surg 63-A: 258–267

    Google Scholar 

  35. Wasielewski RC, Galante JO, Leighty RM, Natarajan RN, Rosenberg AG (1994) Wear patterns of retrieved polyethylene tibial inserts and their relationship to technical considerations during total knee arthroplasty. Clin Orthop 299: 31–43

    Google Scholar 

  36. Weir DJ, Moran CG, Pinder IM (1996) Kinematic condylar total knee arthroplasty. 14-year survivorship. J Bone Joint Surg 78-B: 907–911

    Google Scholar 

  37. Whiteside LA (1994) Cementless total knee replacement. Nine to 11 year results and 10 year survivorship analysis. Clin Orthop 309: 185–192

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cloutier, J.M., Sabouret, P. & Deghrar, A. Total knee arthroplasty with retention of both cruciate ligaments. A 9 to 11 year follow-up study. Eur J Orthop Surg Traumatol 11, 41–46 (2001). https://doi.org/10.1007/BF01706663

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01706663

Key words

Navigation