Late failure and revisions of old-type total knee replacements.

This paper reports the failure rate and survival of old-generation total knee replacements (TKR). Revision operations are also discussed. During a 5-year period from 1974 to 1979, 117 patients, 165 knees, were operated. The prostheses used were Geomedic in 75 knees and Attenborough in 90 knees. Revision was performed in 46 knees (28%). Six knees (4%) were infected. The survival time from implantation averaged 4.3 years, and the followup was 7 to 13 years for the Geomedic (mean 9.7) and 6 to 9 years for the Attenborough (mean 6.7). Mechanical problems were related to loosening of the tibial and femoral components, and revision was required for this reason. The success rate of the revision was 50% at 5.4 years; the less invasive the primary operation, the simpler the revision. Constrained prostheses must be used when ligaments are not intact. In case of infection, removal of the implants is not always necessary.