Related Experiment Video
Updated: May 11, 2026
Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
Survival analysis of total knee arthroplasty at a minimum 10 years' follow-up: a multicenter French nationwide study
J-N Argenson1, S Boisgard, S Parratte
1Orthopedic Surgery Department, Sainte-Marguerite Hospital, Marseille University Hospitals, 270, boulevard Sainte-Marguerite, 13009 Marseille, France. jean-noel.argenson@ap-hm.fr
Introduction:
Survivorship for modern total knee arthroplasties (TKA) is not precisely known from large series, other than registries. The present retrospective study therefore analyzed 846 TKAs at a minimum 10 years' follow-up.
Hypothesis:
Ten-year survivorship for TKAs in a multicenter study exceeds 90%, independently of design and level of prosthetic constraint.
Materials And Methods:
Eight hundred and twenty-eight patients (846 TKAs) were assessed on the Knee Society score. Mean age was 71 years (range, 41-93 years); 274 males and 554 females (67%); 496 patients (60%) were active; diagnosis was principally osteoarthritis (n=752 [89%]). Most TKAs were cemented (n=704 [83%]), replacing the patella (n=668 [79%]) and sacrificed the posterior cruciate ligament (PCL) (n=707 [84%]), 65% being posterior-stabilized and 35% ultracongruent, with fixed (39%) or mobile bearing (61%).
Results:
At a minimum 10 years' follow-up, mean knee score rose from 35 (15-55) to 83 points (74-95), and functional score from 24 (5-45) to 74 points (60-90); mean flexion rose from 105° (25-125°) to 112° (25-125°). Mean hip-knee-ankle angle was 179.5° (169-189°). Sixty-three (7.5%) revision surgeries were required, mainly for loosening (n=18 [2%]) or infection (n=18 [1.8%]). Overall 10-year survivorship was 92% (95% CI: 0.90-0.94). There was no significant difference in survivorship according to implant design or PCL retention. Activity level correlated with revision rate; mechanical complications were more frequent in active and infectious complications in sedentary subjects. Revision was not more frequent in TKA aligned outside the 177-183° range.
Discussion:
Ten-year TKA survivorship was 92%, independently of design and level of mechanical stress. Revision was mainly for infection or loosening, and not for greater than 3° axis misalignment. Mechanical complications were more frequent in younger and more active subjects, for whom therefore other treatment options or technical improvements should be sought.
Level Of Evidence:
Level IV. Retrospective study.