RMC total knee replacement. A review of 166 cases.

This article describes a retrospective analysis of 166 total knee replacements using Richard's Maximum Contact prosthesis. Implant insertion was facilitated by instrumentation to guide the accuracy of the bony cuts; the bony surfaces were prepared using pulsatile lavage, and cement was inserted in a low viscous state. Ninety-four percent of all of the reconstructed knees were within 2 degrees of normal anatomic alignment, and more than 96% of both femoral and tibial components were within 2 degrees of optimal orientation to their respective bones. The radiographic appearance of bone cement radiolucency was 9.5% at 3 years. This was a dramatic improvement, compared with a previous series in which instrumentation and low-viscosity cement were not routinely used (P less than .01). In those cases, however, in which the implant was malaligned, the radiolucency rate was significantly increased (P less than .01). When evaluated with a modified British Orthopaedic Association rating system, decrease in pain was found in almost all patients, regardless of the etiology of their arthritis or of their preoperative score. Correction of deformity and achievement of knee stability were achieved in more than 90% of the knees.