Review of a failed knee replacement and some observations on the design of a knee resurfacing prosthesis.

In a review of failed knee replacements, one design was found to have a seventy-three percent failure rate at three years. In this design the tibial component resembled the MacIntosh prosthesis and the femoral component was polyester. Failure in most cases resulted from generation of wear debris resulting in a severe synovitis and loosening of the femoral component. These findings suggest that the femoral component should be metal and the tibial component plastic, and that if the tibial component is backed with metal, in most cases it need not be cemented in place.