Knee arthroplasty. Our experiences with 22 cases

: In spite of continuing progress, total knee arthroplasty still presents many problems. In this clinic 25 arthroplasties have been performed in 22 patients over the last 4 1/2 years. Guepar hinges were used in 21 knees and Marmor modular knees in 4. Acrylic cement was used in all cases. The mean age of the patients was 69 years. 13 had osteoarthritis, 5 rheumatoid disease and 4 other conditions. There were no serious general complications or infections in the early postoperative period. The commonest local complication was malalignment of the patella (17 cases); 2 of these were complete but reducible dislocations. In only 3 knees did patellar subluxation produce sufficient pain to spoil an otherwise good result. Prostheses have loosened in 2 knees, one of which has been fused with success. Striking features of the early results have been reliable pain relief, improvement of joint movement, and generally an increased walking capacity. In spite of its present problems, arthroplasty remains the procedure of choice in knees where the amount of articular damage contraindicates conservative surgery.