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.