[Arthroplasty using the PCA (porous coated anatomic) knee joint]

A review on the experience and the results with 184 PCA (Porous Coated Anatomic)-knee endoprostheses is given, performed at the Department of Orthopaedic Surgery, Basel, from 1981 to 1984 with an observation period of 6 months to 3 1/2 years. The PCA-knee endoprosthesis will be described and the special surgical technique will be presented. It's possible to implant the PCA-knee endoprosthesis without cement. 60% of our 184 prostheses were inserted without cement, in 19% it was used partially. In 29 of our cases an implantation was performed in both knees at one stage. The PCA-knee-joint is not constrained. It was necessary to perform corrections of the active and passive knee-stabilisators in 28%, a lateral release was performed in 85%. The postoperative flexion reached on an average 95 degrees (+/- 16.7), the deficit of extension 2 degrees (+/- 4) in opposition to 11 degrees (+/- 9) preoperatively. A severe medial instability of ligaments was found postoperatively just in one case, a slight one in 11 cases and a severe lateral instability in one case. Drawer-instability was found only in 5 patients (3 anterior, 2 posterior). 70% of our patients with an average age of 74 years were able to walk postoperatively more than one kilometre (preoperatively 8%) and more than 50% walked without crutches. Postoperative infections occurred in three cases (1.5%), requiring an arthrodesis, a revision and a withdrawal. No complications arose in 86.5%, the most common was found at the patella (9.5%). Based on increasing experiences this complication could also be almost eliminated. We estimate the implantation of the PCA-knee endoprosthesis as recommandable taking care of correct indication and a careful surgical technique.