[Knee prosthesis in 1990. Apropos of a 15 years' experience]

Knee prostheses have been greatly refined over the past ten years. A range of prostheses with various designs are currently used. On the basis of their 15-year experience, the authors assess the role of the various prostheses. Among partial prostheses, the femoropatellar prosthesed have a restricted place and are reserved for isolate degenerative diseases of the femoropatellar joint without femorotibial involvement: 34 such prostheses have been used by the authors and the department of professor J.H. Aubriot in Caen. About 75% of the results are satisfactory, with a follow-up in time of more than 8 years in 6 of these cases. Single-compartment prostheses are used in degenerative disease on an angular deviation, condylar necrosis or post-traumatic lesions, as far as one compartment only is affected. The authors have inserted 115 "Lotus" uni-compartment prostheses at Saint-Louis hospital. 75.6% of these have very good or good results maintained in time, as 72% of the 32 prostheses still produce satisfactory results after 5 years or more. The greatest progress was made above all for total prostheses replacing all the compartments of the knee. Hinge prostheses now have only rare indications as first-intention prostheses due to the immediate vital risks and to the high percentage of suppuration and long-term loosening. Sliding prostheses have taken an increasingly dominant place. The authors used Insall's total condylar prostheses, which do not preserve the posterior cruciate ligament, until 1983. 45 prostheses were followed up for 1 to 10 years, showing 71% of very good or good results.(ABSTRACT TRUNCATED AT 250 WORDS)