Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Posteriorly stabilised (Insall-Burstein) total condylar knee arthroplasty

A follow-up study of 157 knees

  • 37 Accesses

  • 3 Citations


We reviewed 157 knees in 118 patients who underwent posteriorly stabilised (Insall-Burstein) knee replacement arthroplasty. Their mean age at operation was 69 years (range 47 to 85 years) and the average follow-up was 3.5 years (range 2 to 7 years). The “BASK” knee function assessment chart was utilised to evaluate the functional and clinical results. One hundred and thirty-five knees (86%) had excellent or good results, 16 knees (10%) had fair results and six (4%) had poor results. The mean postoperative BASK score was 79 points and the average postoperative knee flexion was 95° (range 65° to 130°). Two patients had a superficial infection, one deep sepsis requiring revision arthroplasty and two mechanical loosening. Patellar impingement symptoms were present in 8% of the knees, although they were troublesome in less than half. Varus alignment of the knee and a varus tilt of the tibial component of more than 2° correlated with the incidence of radiolucent lines around the tibial prosthesis. 90% of the patients were pleased or satisfied with the functional result. The total condylar knee is a safe, reliable and versatile prosthesis.


Nous avons revu 157 genoux chez 118 malades ayant bénéficié d'une arthroplastie par prothèse semi-contrainte (Insall-Burstein). L'âge moyen lors de l'opération était de 69 ans (de 47 à 85) et le recul moyen était de 3 ans et demi (de 2 à 7). Pour évaluer les résultats fonctionnels et cliniques, nous avons eu recours à l'échelle de cotation fonctionnelle «BASK». Le résultat était excellent ou bon dans 135 genoux (86%), moyen dans 16 (10%) et mauvais dans 6 (4%). La cotation post-opératoire «BASK» était en moyenne de 79 points et la flexion post-opératoire moyenne de 95° (de 65° à 130°). Deux opérés avaient présenté une infection superficielle, un seul un sepsis profond ayant nécessité une reprise de l'arthroplastie et deux un descellement mécanique. Des signes d'hyperpression rotulienne pouvaient être notés dans 8% des genoux mais ils n'avaient de traduction clinique que dans moins de la moitié des cas. L'existence d'un liseré autour de la pièce tibiale êtait correlée avec une désaxation du genou en varus ou avec un positionnement en varus du composant tibial supérieur à 2°. La prothèse total-condylar est donc sûre, efficace et susceptible de s'adapter aux diverses éventualités.

This is a preview of subscription content, log in to check access.


  1. 1.

    Aglietti P, Buzzi R (1988) Posteriorly stabilised total condylar knee replacement: three to eight years' follow-up of 85 knees. J Bone Joint Surg [Br] 70: 211–216

  2. 2.

    Aglietti P, Rinonapoli E (1984) Total condylar knee arthroplasty: a five-year follow-up study of 33 knees. Clin Orthop 186: 104–111

  3. 3.

    Ahlberg A, Linden B (1977) The radiolucent zone in arthroplasty of the knee. Acta Orthop Scand 48: 687–690

  4. 4.

    Aichroth PM, Freeman MAR, Smillie IS, Souter WA (1978) A knee function assessment chart. J Bone Joint Surg [Br] 60: 308–309

  5. 5.

    Bargren JH, Blaha JD, Freeman MAR (1983) Alignment in total knee arthroplasty: correlated biomechanical and clinical observations. Clin Orthop 173: 178–183

  6. 6.

    Cameron HU, Freeman MAR (1979) The radiolucent line around bone cement. Acta Orthop Belg 45: 75–78

  7. 7.

    Cornell CN, Ranawat CS, Burstein AH (1986) A clinical and radiographic analysis of loosening of total knee arthroplasty components using a bilateral model. J Arthr 1: 157–163

  8. 8.

    Dorr LD (1985) Complications: loosening of the cementbone interface after total knee arthroplasty. In: Ranawat CS (ed.) Total-condylar knee arthroplasty: technique, results and complications. Springer, New York Berlin Heidelberg, pp 173–185

  9. 9.

    Dorr LD, Scott RD, Ranawat CS (1985) Importance of retention of the posterior cruciate ligament. In: Ranawat CS (ed) Total-condylar knee arthroplasty: technique, results and complications. Springer, New York Berlin Heidelberg, pp 197–202

  10. 10.

    Ducheyne P, Kagan A II, Lacey JA (1978) Failure of total knee arthroplasty due to loosening and deformation of the tibial component. J Bone Joint Surg [Am] 60: 384–391

  11. 11.

    Figgie E III, Goldberg VM, Heiple KG, Moller HS III, Gorden NH (1986) The influence of tibial-patellofemoral location on function of the knee in patients with the posterior stabilised condylar knee prosthesis. J Bone Joint Surg [Am] 68: 1035–1040

  12. 12.

    Hood RW, Vanni M, Insall JN (1981) The correction of knee alignment in 225 consecutive total condylar knee replacements. Clin Orthop 160: 94–105

  13. 13.

    Hvid I, Nielsen S (1984) Total condylar knee arthroplasty: prosthetic component positioning and radiolucent lines. Acta Orthop Scand 55: 160–165

  14. 14.

    Insall JN (1984) Total knee replacement. In: Insall JN (ed) Surgery of the knee. Churchill Livingstone, New York, pp 587–695

  15. 15.

    Insall JN, Hood RW, Flawn LB, Sullivan DJ (1983) The total condylar knee prosthesis in gonarthrosis: a five to nine-year follow-up of the first one hundred consecutive replacements. J Bone Joint Surg [Am] 65: 619–628

  16. 16.

    Insall JN, Lachiewicz PF, Burstein AH (1982) The posterior stabilised condylar prosthesis: a modification of the total condylar design: two to four-year clinical experience. J Bone Joint Surg [Am] 64: 1317–1323

  17. 17.

    Kjaersgaard-Andersen P, Hvid I, Wethelund J-O, Sneppen O (1989) Total condylar knee arthroplasty in osteoarthritis: a four to six-year follow-up evaluation of 103 cases. Clin Orthop 238: 167–173

  18. 18.

    Laskin RS (1981) Total condylar knee replacement in rheumatoid arthritis: a review of one hundred and seventeen knees. J Bone Joint Surg [Am] 63: 29–35

  19. 19.

    Lotke PA, Ecker ML (1977) Influence of positioning of prosthesis in total knee replacement. J Bone Joint Surg [Am] 59: 77–79

  20. 20.

    Merchant AC, Mercer RL, Jacobsen RH, Cool CR (1974) Roentgenographic analysis of patellofemoral congruence. J Bone Joint Surg [Am] 56: 1391–1396

  21. 21.

    Ranawat CS (1985) Future trends in knee arthroplasty. In: Ranawat CS (ed) Total-condylar knee arthroplasty: technique, results and complications. Springer, New York Berlin Heidelberg, pp 168–171

  22. 22.

    Ranawat CS, Rose HA (1985) Clinical and radiographic results of total-condylar knee arthroplasty: a 3- to 8-year follow-up. In: Ranawat CS (ed.) Total-condylar knee arthroplasty: technique, results and complications. Springer, New York Berlin Heidelberg, pp 140–148

  23. 23.

    Rand JA, Coventry MB (1980) Stress fractures after total knee arthroplasty. J Bone Joint Surg [Am] 62: 226–233

  24. 24.

    Scott RD, Volatile TB (1986) Twelve years' experience with posterior cruciate-retaining total knee arthroplasty. Clin Orthop 205: 100–107

  25. 25.

    Scott WN, Rubinstein M (1987) Failure rate of primary total knee replacement. In: Scott WN (ed) Total knee revision arthroplasty. Grune and Stratton, New York, pp 1–8

  26. 26.

    Scott WN, Rubinstein M, Scuderi G (1988) Results after knee replacement with a posterior cruciate-substituting prosthesis. J Bone Joint Surg [Am] 70: 1163–1173

  27. 27.

    Scuderi GR, Insall JN, Windosr RE, Moran MC (1989) Survivorship of cemented knee replacements. J Bone Joint Surg [Br] 71: 798–803

  28. 28.

    Sledge CB, Walker PS (1984) Total knee arthroplasty in rheumatoid arthritis. Clin Orthop 182: 127–136

  29. 29.

    Sneppen O, Christensen P, Larsen H, Vang PS (1981) Mechanical testing of trabecular bone in knee replacement: development of an osteopenetrometer. Int Orthop 5: 251–256

  30. 30.

    Tew M, Waugh W (1985) Tibiofemoral alignment and results of knee replacement. J Bone Joint Surg [Br] 67: 551–556

  31. 31.

    Vince KG, Insall JN, Kelly MA (1989) The total condylar prosthesis: 10 to 12-year results of a cemented knee replacement. J Bone Joint Surg [Br] 71: 793–797

Download references

Author information

Additional information

Reprint requests to: P. M. Aichroth

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Patel, D.V., Aichroth, P.M. & Wand, J.S. Posteriorly stabilised (Insall-Burstein) total condylar knee arthroplasty. International Orthopaedics 15, 211–218 (1991). https://doi.org/10.1007/BF00192297

Download citation


  • Tibial Component
  • Nous Avons
  • Radiolucent Line
  • Varus Alignment
  • Replacement Arthroplasty