Hybrid total knee arthroplasty. Two- to five-year results using the Miller-Galante prosthesis

Forty-one "hybrid" Miller-Galante total knee prostheses having porous-coated femoral and patellar components and a tibial component without a keel, cemented using low-viscosity technique, were implanted and prospectively evaluated for two to five years. The surgical technique was accurate, restoring the mechanical axis of the lower extremity to an average of 1.6 degrees varus. The average postoperative knee score was 90 points with 88% good or excellent results and 88% completely painless. Range of motion improved from a mean 88 degrees to a mean 108 degrees. Nonprogressive, incomplete radiolucent lines were present at the bone prosthesis interface in 27% of patellar, 15% of femoral, and 20% of tibial components. There were six patellar component fractures, four of which have been revised. These clinical and roentgenographic results support the "hybrid" technique for total knee arthroplasty. However, the use of the porous-coated, metal-backed patellar component is not recommended.