SEVEN-YEAR RESULTS OF A CONSECUTIVE SERIES OF 105 POSTERIOR STABILISED HLSII TOTAL KNEE PROSTHESES

Purpose: Posterior stabilisation with a third condyle was introduced by Henri Dejour with the HLSI prosthesis. While the posterior stabilisation process has been validated, this implant still raises some problems with the tibial fixation in patients with advanced joint degeneration, leading to the development of the HLSII model. The purpose of the present retrospective work was to evaluate functional outcome and persistance of the HLSII prosthesis fixation. Material and methods: Between January 1992 and December 1993, 105 total knee arthroplasties (TKA) were performed in 94 consecutive patients using posterior stabilised HLSII prostheses. Indications were joint degeneration (40% stage 4) in 78% and polyarthritis in 19%. None of the patients were lost to follow-up but 14 patients died, six were bedridden (stroke sequela) and four were contacted by phone only. In all, 70 patients (77 TKA), mean age 66 years (22–79) were retained for clinical and radiological assessment at mean follow-up of seven years (range 6–8 years). All implants were cemented and the patella was resurfaced in all cases. Eight operators participated in this series. Junior surgeons (n=5) implanted one-third of the prostheses. Results: The mean IKS knee score rose from 27±18 points (0–63) preoperatively to 81±18 (21–100) at last follow-up, function score from 35±20 (0–75) to 64±24 (0–100) (P Discussion: Good axial control emphasises the reliability of the instrumentation since one-third of the prostheses were implanted by junior surgeons. Improvements in tibial fixation with the HLSII appear to be effective, particularly for stage 4 degeneration. Long-term surveillance is however necessary. The femoropatellar joint can give rise to non-infectious complications and should be improved. The concept of posterior stabilisation with a third condyle authorises good flexion amplitude and favours use of stairs.