Results with the constrained total knee prosthesis in treating severely disabled XXXX and @entity1 with failed total knee replacements.

@entity1 @entity691 @entity27760 @entity5144 @entity177 @entity281 @entity158 @entity1159 @entity282
Fifty-fix constrained total knee replacements (forty Guepar and sixteen Herbert prostheses) were performed in forty-nine severely disabled @entity5144 @entity1 and they were followed for two to four years. Seventeen of these knees were operated on to salvage a failed prosthesis. Good relief of @entity158 was achieved in 64 per cent of the knees but there was less improvement in walking and function. The over-all range of motion increased because of a reduction in preoperative @entity1159 . The results in the salvage group were less successful than in those @entity1 who underwent a primary operation. Between six months and one year postoperatively, @entity158 had developed in 17 per cent of the fifty-six knees, 9 per cent had walking difficulties, and 7 per cent lost function. @entity158 accounted for the unfavorable @entity158 ratings in over half of the knees. Zonal roentgenographic analysis of each knee indicated high incidences of radiolucent lines at the cement-bone interface (75 per cent), cement-metal lucencies (68 per cent), and @entity27760 (73 per cent). Forty-three per cent of the knees showed excessive posterior placement of the prosthesis of more than five millimeters, resulting in @entity1159 of as much as 5 degrees. Complications requiring reoperation developed in nine knees (16 per cent). There was one case of loosening and three knees had @entity281 . @entity282 were present in 48 per cent of the knees. The use of either a cemented metal-on-metal hinged knee replacement or a metal-on- @entity691 hinge type of prosthesis was found to result in a relatively high incidence of @entity177 and complications, and did not solve the problem of treating @entity1 with a failed knee prosthesis.
