Long-term followup of the bone-ingrowth Ortholoc knee system without a metal-backed patella

Between June 1981 and January 1984, 265 Ortholoc-I femoral and tibial components were implanted using bone-ingrowth technique in 202 patients. Five knees (five patients) were lost to followup and 66 knees were excluded because the patients died, leaving 184 knees (165 patients) with 15 to 18 years followup. One knee loosened during the 15- to 18-year followup period and was revised, and five knees were revised for infection. Survival rate at 18 years considering loosening was 98.6%. At 15 years after surgery, 79.9% of patients did not have pain, 10.1% had mild pain, 8% had moderate pain, and 2% had severe pain. At 18 years after surgery, 77.6% did not have pain, 7.2% had mild pain, 5.2% had moderate pain, and 1% had severe pain. Knee flexion was 110 degrees preoperatively and increased to a mean of 115 degrees at 2 years postoperative, then remained unchanged for the rest of the followup. Intramedullary alignment proved to be highly effective, and has become the standard for total knee arthroplasty instrumentation systems. Total knee replacement with bone-ingrowth technique was a reliable and effective means of treating the end-stage arthritic knee. In patients who required revision surgery, excellent bone stock remained and revision with bone-ingrowth technique was accomplished easily.