4- to 10-year results with the anatomic modular total knee.

The outcome of 186 consecutive total knee arthroplasties performed with the Anatomic Modular Knee is reported. One hundred forty-two knees had followup of 4 to 10 years (mean, 6.9 years). Two knees required revision of all components, one because of infection and the other for instability. Seven patients underwent exchange of the modular tibial polyethylene insert at an average of 84 months postoperatively. The mean age of these seven patients at primary arthroplasty was 54 years. No implant showed clinical or radiographic evidence of loosening and there were no complications related to patellofemoral articulation. The revision rate of the femoral, tibial, and patellar components was two of 142 or 1.4%. The revision rate including exchange of the polyethylene insert was nine of 142 or 6.3%. This minimally constrained posterior cruciate retaining modular design performed well at intermediate followup. The absence of patellofemoral complications and aseptic loosening was notable. Wear related phenomena were the most common indications for reoperation and these occurred in younger, active individuals with relatively thin polyethylene bearings. The relative value of modular tibial inserts and the outcome of isolated polyethylene exchanges warrant additional study.