Erfahrungen mit der Knie-Totalendoprothese nach Blauth

Abstract

Following a brief review of the differential indication for total prosthesis of the knee joint, the article reports on 136 implantations of the hinged prosthesis according to Blauth. In 94% of the cases the results were good and very good (n = 66) within an average follow-up examination period of 2 years. One of the main features of the success of the treatment is the relief from pain achieved with this prosthesis provided it functions well. Differentation of the treatment results according to the basic underlying disease (rheumatoid arthritis; pangonarthrosis) shows that good results were achieved particularly in relatively young rheumatic patients thanks to their co-operative capacity during the follow-up treatment period. The following relevant complications were seen among the 136 implantations: one early infection, three late infections, two deaths due to cardiovascular general complications, and one fatal case of sepsis as a result of a late infection. The rate of the aseptic loosenings was 1.5% only, and hence favourably low, as was evident from the follow-up examinations of the implanted knee joints. Lateralisation of the patella, which occurred in one-half of the cases, is attributed by us to an intraoperative weakening of the medial patella ligament (which acts as an auxiliary extension apparatus). We intend to counteract this in future via an additional lateral capsular discision. The follow-up study presented here confirms the efficiency of the Blauth model, as well as the generally valid indication criteria for total implantation of the knee joint.