Long-Term Results of the SVL Total Knee Arthroplasty

PURPOSE OF THE STUDY The aim of the study was to evaluate the long-term results of the total knee replacement Beznoska SVL implanted at the 1st Department of Orthopaedic Surgery, 1st Faculty of Medicine, Charles University and Motol University Hospital Prague, in the 1997/2009 period. MATERIAL AND METHODS The SVL implant is a non-constrained knee replacement, anatomically similar to the bone it replaces, which preserves the posterior cruciate ligament. A total of 1101 knee joint replacements were evaluated in 973 patients, of whom 128 underwent bilateral arthroplasty. Kaplan-Meier curves were used to estimate the cumulative survival of implants. Clinical outcomes were assessed using the Knee Society clinical rating system (KS score) and radiographic data evaluation was also included. RESULTS Using KS scores, the results were excellent in 997, good in 75, satisfactory in 19 and poor in 10 knees. The average range of motion was 0.16 to 106.31 degrees. The complications included flexion contracture, as the most frequent problem (13 knees), 10 knees were infected, aseptic loosening due to polyethylene granuloma was found in eight knees and anterior knee pain was experienced in six cases. At follow-up of 12.5 years implant survivorship was 98 %, as evaluated by the Kaplan-Meier analysis. DISCUSSION A comparison of SVL implant survivorship with other knee replacement designs is discussed. It should be emphasized that the clinical outcome depends not only on implant quality, but also on the operative technique used and the surgeon's experience and skills. It is the SVL system that allows for the balancing of knee joint stability and thus enables even less experienced surgeons to make use of a more sophisticated implantation technique. CONCLUSIONS Total knee replacement using the SVL Beznoska implant is a safe, reliable and economic treatment with excellent clinical outcomes.