The Insall-Burstein total knee replacement in osteoarthritis: a 10-year minimum follow-up.

A total of 99 Insall-Burstein posterior stabilized (IBPS) knee replacements were implanted in 86 osteoarthritic patients. We reviewed 60 knees with a 10- to 15-year follow-up. Using the Knee Society score, 35 knees (58\%) were excellent, 15 (25\%) good, 4 (7\%) fair, and 6 (10\%) poor. Flexion at follow-up was 106 degrees on average. Moderate patellofemoral crepitation was present in 5 knees (9\%), and 11 knee required excision of a synovial nodule proximal to the patella. Radiographic analysis showed 5 osteolytic lesions (8\%) around well-fixed tibial and femoral components and minimal (1 mm) narrowing of the medial polyethylene thickness in 7 knees (12\%). There were 6 (10\%) failures requiring reoperation because of aseptic loosening (4 knees), deep infection (1 knee), and recurrent patellar dislocation (1 knee). Survivorship analysis using revision as the endpoint showed a cumulative success rate of 92\% at 10 years. In this study, the IBPS knee has shown good long-term results with low rates of aseptic loosening and no failures attributable to polyethylene wear.