The Freeman-Swanson ICLH total knee arthroplasty. Complications and problems

Seventy Freeman-Swanson ICLH total-knee arthroplasties were performed in fifty-eight patients. Five major prosthetic problems and complications were encountered: (1) instability, (2) abnormal prosthetic insertion, (3) prosthetic loosening, (4) patellofemoral abnormalities, and (5) cement debris. These major problems and other complications resulted in an over-all reoperation rate of 28.5 per cent. Instability and abnormal prosthetic insertion seemed to be the primary factors that led to loosening. Eight knees were revised with other prostheses while three were fused because of gross loosening and instability. Two additional knees required an arthrodesis because of deep infection, resulting in a failure rate of 18.5 per cent. Clinical and roentgenographic abnormalities appeared to correlate with the failures of this total knee replacement. Modifications in the prosthetic design and improved surgical technique could obviate many of these complications and problems.