Long-term results of the Accord total knee replacement in the Countess of Chester Hospital

Between 1985 and 1996, 74 knees in 61 patients were replaced with a cemented Accord total knee arthroplasty at the Countess of Chester Hospital. This prosthesis is of an unconstrained meniscal-bearing design. At the time of study, 16 patients with 20 knees had died, six knees were lost to follow-up and one knee had become infected. Twenty-five knees had been revised or undergone further surgery (including four knees in deceased patients); these were classed as failures. Twenty-four patients with 26 knees still in situ were reviewed between July and September 1998. They were assessed clinically according to the Knee Society Scoring system and radiographically with weight-bearing antero-posterior and lateral films. The mean knee score was 60, and the mean function score was 42. Of the 25 knees that had failed, 19 had been revised for instability. Survivorship was 58% at 10 years with an average follow-up of 5 years 4 months. These results are poor compared with those reported on more conventional total knee replacements. The authors urge that new implants should be viewed critically because of the absence of long-term results, no matter how good their theoretical advantages appear to be.