[Long-term results of Insall's total condylar knee prosthesis (10-to-13-year follow-up)]

Published online: Mar 27 1995

Z Jaffar-Bandjee, F Lecuire, M Basso, and J Rebouillat.

Service d'Orthopédie traumatologie, Centre Hospitalier Départemental Felix Guyon, La Réunion, France.


We have studied 10 to 13 years postoperatively the first 105 total knee arthroplasties using the Total Condylar, a semiconstrained prosthesis with sacrifice of the cruciate ligaments, inserted between 1979 and 1983, in 99 patients (6 were bilateral). The average age of these patients was 73.5 years at the time of arthroplasty. At the time of this review, 46 patients had died (49 prostheses) and 10 were lost to follow-up. Five knees had failed (4 infections), requiring prosthesis removal in three cases. The other 38 patients (41 knees) survived: 35 were available for detailed clinical and roentgenographic evaluation, 6 knees had only a clinical, x-ray, questionnaire or telephone evaluation. To evaluate the results of these prostheses, we used 3 different rating systems the SOFCOT rating system the Hospital for Special Surgery rating system the new scoring system of the Knee Society. The results with the HSS system were excellent or good in 80% of the cases. The rate of satisfactory results, somewhat lower than those of North American studies, is probably explained by the advanced age of our patients. All these prostheses were cemented. There was no aseptic loosening at 10 to 13 years follow-up. In assessing these results we can confirm the reliability of the first model of the Insall prosthesis, in spite of a small range of sizes, and of a rudimentary ancillary, which resulted in important positioning mistakes. We can confirm that a cemented knee prosthesis with sacrifice of the cruciate ligaments is reliable at more than 10 years of follow-up. The technical advancements: larger range of component sizes metal backed tibial plates better ancillary, which permits exact and reproducible placement posterially-stabilized system should yield even better long-term results, approaching those of total hip arthroplasty.