Long-term follow-up evaluation of 1000 consecutive cemented total knee arthroplasties

This is a report of a retrospective study of 1000 consecutive, cemented total knee arthroplasties performed by one surgeon from January 1976 to August 1989. Eighty-five percent of the patients were available after a mean of 51 months. Using The Knee Society Clinical Rating System, a good to excellent result was found in 95% of the knees; function was good to excellent in 54% of the knees. By using an actuarial method, 94% of the knees can be expected to survive 13 years. A deep venous thrombosis or pulmonary embolus was found in 1.7% and was no less common in the 25% of the patients who received pharmacologic anticoagulation. The mortality rate was 0.4%. The infection rate was 0.7% and did not correlate with intraoperative cultures. There were 14 failures for a variety of reasons, and six unsuccessful knees were revised. Preoperative medical problems did not generally predict the postoperative complications. The average duration of hospitalization during the last five years of the study was 9.7 days. Careful and consistent preoperative, intraoperative, and postoperative care is responsible for the low complication rate. The cemented knee arthroplasty consistently continues to yield good results.