A non-constrained total knee prosthesis designed at St. Luc Hospital,
Montreal, has been used there since 1977. The geometry of its femoral
component simulates the normal anatomy of the knee and the flat articular
surfaces of its tibial component allow unconstrained rotation, rolling, and
sliding motion, as dictated by the retained cruciate ligaments. The results
achieved in the first 107 consecutive arthroplasties (in eighty-three
patients) were evaluated after a minimum follow-up of two years (range, two
to four and one-half years). Using the knee-rating system of The Hospital
for Special Surgery, 91 per cent of the knees had an excellent or good
result. In ninety-eight knees the preoperative pain was adequately relieved
and the limb was in physiological valgus alignment. One hundred and four
knees had normal medial-lateral stability in extension, and three were
unstable. The average postoperative arc of flexion was 102.8 degrees.
Sixty-three patients (76 per cent) could ascend and descend stairs
normally, and gait studies on seventeen of these patients (twenty-three
involved knees) demonstrated that the flexion arc of the knee while the
patients were ascending and descending stairs was the same as that of
normal controls. Three knees had a deep wound infection and one knee had
aseptic loosening of the femoral component.