The Swedish knee arthroplasty register. A nation-wide study of 30,003 knees 1976-1992.

1976 through 1992, 30,003 primary knee arthroplasties and their revisions have been recorded in a nation-wide Swedish study. We report on the structure of the register, demographic data and survivorship. We found that operations for osteoarthrosis (OA) counted for the increase in number of arthroplasties in contrast to rheumatoid arthritis (RA), where the number had slightly declined. For primary operations, the total knee prostheses have practically eliminated other types in RA and are steadily gaining popularity in OA at the expense of the unicompartmental prostheses. Total knee replacements showed gradually improving survival even in unchanged designs while the unicompartmental prostheses don't, partly because of newly introduced inferior designs. We also found that failed unicompartmental prostheses were best replaced with a tricompartmental prosthesis and that a total revision was to be preferred when a tricompartmental tibial component failed. The risk of the most devastating complications, e.g., infection, leading to extraction of the prosthesis or arthrodesis has decreased considerably also in the last years.