Reduced Failure Rate in Knee Prosthetic Surgery With Improved Implantation Technique

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Abstract
From the Swedish Knee Arthroplasty project, started in 1975, types of relatively unmodified knee prostheses were chosen for analysis of time-dependent changes in the failure rate. One thousand nine hundred sixty-nine Marmor unicompartmental and 376 Total Condylar arthroplasties, all cemented, were followed until the end of 1989. The cumulative revision rates calculated with survival statistics showed a continuous improvement with time. The five-year revision rate was reduced from 11% to 5% for the Marmor prosthesis and from 10% to 2% for the Total Condylar prosthesis. This indicates that factors other than improved design are important. Such factors could include improved guide instruments, better surgical and cementing technique, influence of a learning curve, and patient selection.

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