A novel knee implant for total knee arthroplasty meets expectations at 10 years. First long‐term follow‐up report of clinical outcomes and survivorship

Purpose: Achieving a “forgotten knee” after total knee arthroplasty (TKA) remains a primary goal in modern knee replacement surgery. Anatomic implant designs aim to replicate native knee anatomy and kinematics, potentially improving patient satisfaction and functional outcomes. This study evaluates the long-term clinical outcome and survivorship of the Persona Knee System at a minimum follow-up of 10 years. Methods: 116 TKAs performed using the Persona Posterior Stabilised (PS) Knee System (Zimmer Biomet, Warsaw, Indiana, USA) between 2013 and 2014 at a high-volume orthopaedic centre were prospectively followed and retrospectively analysed. Clinical outcomes were assessed using patient-reported outcome measures (PROMs), including the Forgotten Joint Score-12 (FJS-12), Oxford Knee Score (OKS), and Western Ontario and McMaster Universities Arthritis Index (WOMAC). Implant survivorship was determined using Kaplan-Meier analysis, and complication rates were recorded. Results: At a mean follow-up of 11.1 years, 116 knees were available for analysis. Patients were assessed clinically and radiographically at 1, 3 and 6 months postoperatively, and then annually, with a mean follow-up of 11.1 years. The mean FJS-12 was 69.52 (SD 12.21, range 15–88), indicating a high level of joint awareness reduction. The OKS and WOMAC scores significantly improved postoperatively, with mean final values of 38.63 (SD 7.99, range 7–48) and 25.29 (SD 16.97, range 4–91), respectively. Radiological analysis demonstrated accurate and stable implant positioning, with no progressive radiolucent lines in non-revised cases. Kaplan–Meier survival analysis showed a 95.7% (SD 1.9%) implant survival rate. The revision rate was 4.3%, with aseptic loosening and persistent painful prosthesis as the primary causes. Conclusion: The anatomic design of the Persona Knee System provides excellent long-term clinical outcomes, high patient satisfaction, and sustained implant durability. Future research should further investigate patient-specific factors and surgical refinements to optimise long-term outcomes in TKA. Level of Evidence: Level III.