The Genesis total knee prosthesis: a 10-year followup study

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• Osteoarthritis necessitates joint replacement surgery.
• Total knee replacement (TKR) is a common procedure for end-stage osteoarthritis.
• The Genesis prosthesis is a widely used implant for TKR.

Purpose of the Study:

• To evaluate the long-term outcomes of primary cemented total knee replacement using the Genesis prosthesis.
• To compare the results of sacrificing versus retaining the posterior cruciate ligament in TKR.
• To assess pain relief, range of motion, radiolucencies, and survivorship at a minimum 10-year follow-up.

Main Methods:

• Prospective study of 100 consecutive patients undergoing primary cemented TKR with the Genesis prosthesis.
• Patients were followed for at least 10 years post-surgery.
• Two groups were analyzed: posterior cruciate ligament (PCL) sacrificed and PCL retained. Posterior-stabilized components were used when PCL was sacrificed.

Main Results:

• Over 95% of patients in both groups reported excellent pain relief.
• Mean flexion was 114 degrees (PCL sacrificed) and 117 degrees (PCL retained).
• Tibial radiolucencies were significantly lower in the PCL-sacrificed group (2%) compared to the PCL-retained group (12%).
• At 10 years, 76% of PCL-retained and 75% of PCL-sacrificed groups had excellent results.
• Survivorship was high in both groups: 96% (PCL retained) and 97% (PCL sacrificed).

Conclusions:

• Primary cemented total knee replacement with the Genesis prosthesis provides excellent long-term pain relief and functional outcomes.
• Sacrificing the posterior cruciate ligament may be associated with fewer tibial radiolucencies without compromising clinical results or survivorship.
• The Genesis prosthesis demonstrates robust long-term performance, supporting its use in total knee replacement surgery.