Dislocation of Rotating-Hinge Knee Prostheses with Antidislocation Mechanism

Pacha-Vicente, Daniel; Malik, Amer; Castellet-Feliu, Enric; Nardi-Vilardaga, Joan

doi:10.1016/j.arth.2006.11.020

Cited by 24 publications

(18 citation statements)

References 7 publications

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“…Although the survival was similar in the current series of patients with the OSS TM , the followup in the OSS TM series was twice as long. Other studies have noted problems with dislocation of the Endo-Model 1 implant, despite an antidislocation feature [24,35,36]. Femoral-tibial dislocations occurred in two knees in our Endo-Model 1 series whereas none were observed in the current study.…”

Section: Discussioncontrasting

confidence: 60%

Distal Femoral Replacement in Nontumor Cases with Severe Bone Loss and Instability

Berend

Lombardi

2009

Clinical Orthopaedics &Amp; Related Research

127

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Section: Discussioncontrasting

confidence: 60%

Distal Femoral Replacement in Nontumor Cases with Severe Bone Loss and Instability

Berend

Lombardi

2009

Clinical Orthopaedics &Amp; Related Research

127

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“…On the contrary, the Endo-Model (Waldemar Link GmbH and Co.KG) has the shortest peg, and therefore this device would need the least distraction to dislocate. Nevertheless, this implant seems to be a safe design because of the mechanical antidislocation feature [15, 18]. …”

Section: Discussionmentioning

confidence: 99%

Evaluation of Stability of Rotating Hinge Knee Prostheses: A Biomechanical Study

et al. 2013

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Purpose. Rotating hinge knee prostheses should provide a stable situation following reconstruction. We performed a biomechanical analysis to establish the association between design of the central rotational stem (peg) and implant's stability, in a theoretical setting. Methods. Six different rotating hinge designs were tested, and three observers performed two different measurements with a custom made biomechanical apparatus and laterally directed pressure. The aim was to assign the degree of tilting of the peg within the vertical post-in channel by extending the distraction as well as the maximum amount of distraction before the peg's dislocation. An intraclass-correlation coefficient (ICC) was calculated to determine the observer's reliability. Results. Implant designs with cylindrical pegs of different lengths were superior to implant designs with conical or other shaped pegs concerning stability and maximum amount of distraction before dislocation, showing steep rising distraction-angular displacement curves. The ICC at 15 mm and 25 mm of distraction revealed high interobserver reliability (P < 0.001). Conclusion. The biomechanical analysis showed that rotating hinge prostheses with long and cylindrical pegs have the highest stability at any given amount of distraction. Designs with shorter and markedly tapered pegs may become unstable under conditions of mild joint distraction which has to be proven in future in vivo investigations.

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“…Despite these findings, major complication rates ranging from 0% to 44% at 3.8 to 15 years have been reported secondary to infection, aseptic loosening, patellar instability, and prosthetic dislocation [6,16]. Less common modes of failure also have been identified, including failure of the polyethylene bushing [20], fracture of the tibial metal post [18], fracture of the tibial yoke [8], failure of an antidislocation mechanism [12], and tibiofemoral distraction disengagement [21].…”

Section: Discussionmentioning

confidence: 99%

Case Report: Failure of Rotating-hinge Total Knee Prosthesis by Disengagement of the Hinge-post Extension

Biswas

Haughom

Mayle

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Although modern-generation rotating-hinge knee implants have been modified to mitigate earlier complications related to aseptic loosening with these devices in revision TKAs, there are few, if any, reports of failure related to the hinge mechanism in these prostheses. Case Description We present a case of disengagement of the hinge-post extension in a contemporary rotating-hinge knee prosthesis originally implanted during revision surgery for instability and extensor mechanism insufficiency. We hypothesize the screw home kinematics of the knee resulted in a counterclockwise torque, contributing to the hinge post locking screw disengagement in this case. Literature Review Although some authors have reported complications and failures related to aseptic loosening with rotating-hinge knee prostheses, there have been no reports regarding complications related to the hinge mechanism, which simultaneously links and permits rotation between the femoral and tibial components. Clinical Relevance Arthroplasty surgeons who use rotating-hinge knee prostheses need to be aware of this potential mode of failure. Design modifications, including more secure locking mechanisms and side-specific implants, may avoid this complication.

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Dislocation of Rotating-Hinge Knee Prostheses with Antidislocation Mechanism

Cited by 24 publications

References 7 publications

Distal Femoral Replacement in Nontumor Cases with Severe Bone Loss and Instability

Distal Femoral Replacement in Nontumor Cases with Severe Bone Loss and Instability

Evaluation of Stability of Rotating Hinge Knee Prostheses: A Biomechanical Study

Case Report: Failure of Rotating-hinge Total Knee Prosthesis by Disengagement of the Hinge-post Extension

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