Seven-year survivorship and functional outcomes of the high-flexion Vanguard complete knee system

Certain recreational, cultural, occupational, and religious practices may require knee flexion exceeding typical daily living activity needs. Some total knee prostheses mechanically accommodate high flexion to help meet such demands, e.g., the Vanguard knee (Biomet, Inc., Warsaw, IN) which can mechanically achieve 140°-145°. This multicenter, prospective clinical study of 957 Vanguard knees (865 patients) examined mid-term outcomes. The Kaplan-Meier survivorship estimate was 97.8% (95% CI: 96.5-98.7%) at 7.0 years. For patients with ≥ 2-year follow-up (n=627), mean peak flexion increased from 116.8° to 124.8° (P<0.001). For knees with pre-operative flexion of <95°, 95°-105°, and >105°, the mean increases were 27.8°, 22.0°, and 3.6°, respectively. Mean Knee Society Knee and Function scores increased from 45.9 and 45.5 points to 92.0 and 73.8 points, respectively (P<0.001).