High ten-year implant survivorship and low patellofemoral complication rate for S-ROM rotating-hinge implants in revision total knee arthroplasty

Matar, Hosam E; Bloch, Benjamin V.; James, Peter

doi:10.1302/2633-1462.33.bjo-2021-0151.r1

Cited by 6 publications

(6 citation statements)

References 30 publications

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“…A number of studies on contemporary rotating-hinge implants in rTKA have been published, although most with short-to medium-term outcomes with various implants. 9,[20][21][22][23][24][25] Our study has long-term follow-up with low complication and revision rates for any cause. However, our study is limited by retrospective nature of its design and lack of clinical scores.…”

Section: Discussionmentioning

confidence: 99%

Satisfactory medium- to long-term outcomes of cemented rotating hinge prosthesis in revision total knee arthroplasty

Matar,

Bloch,

James

2023

Bone Jt Open

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AimsThe aim of this study was to evaluate medium- to long-term outcomes and complications of the Stanmore Modular Individualised Lower Extremity System (SMILES) rotating hinge implant in revision total knee arthroplasty (rTKA) at a tertiary unit. It is hypothesized that this fully cemented construct leads to satisfactory clinical outcomes.MethodsA retrospective consecutive study of all patients who underwent a rTKA using the fully cemented SMILES rotating hinge prosthesis between 2005 to 2018. Outcome measures included aseptic loosening, reoperations, revision for any cause, complications, and survivorship. Patients and implant survivorship data were identified through both prospectively collected local hospital electronic databases and linked data from the National Joint Registry/NHS Personal Demographic Service. Kaplan-Meier survival analysis was used at ten years.ResultsOverall, 69 consecutive patients (69 knees) were included with a median age of 78 years (interquartile range 69 to 84), and there were 46 females (66.7%). Indications were septic revisions in 26 (37.7%), and aseptic aetiology in the remining 43 (62.3%). The mean follow-up was 9.7 years (4 to 18), and the overall complication was rate was 7.24%, all with patellofemoral complications. Failure rate with ‘any cause revision’ was 5.8%. There was one case of aseptic loosening of the femoral component. At ten years, 17/69 patients (24.63%) had died, and implant survivorship was 92.2%.ConclusionIn our experience, the SMILES rotating hinge prosthesis achieves satisfactory long-term outcomes with ten-year implant survivorship of 92.2% and a patellofemoral complication rate of 7.24%.Cite this article: Bone Jt Open 2023;4(10):776–781.

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Section: Discussionmentioning

confidence: 99%

Satisfactory medium- to long-term outcomes of cemented rotating hinge prosthesis in revision total knee arthroplasty

Matar,

Bloch,

James

2023

Bone Jt Open

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“…all patients with a rh tKa had less than antigravity quadriceps strength. 10 Statistical analysis. data are presented as mean values with ranges for continuous variables and counts with percentages for categorical variables, unless otherwise specified.…”

Section: Methodsmentioning

confidence: 99%

Primary total knee arthroplasty in patients with post-polio syndrome

et al. 2023

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AimsKnowledge on total knee arthroplasties (TKAs) in patients with a history of poliomyelitis is limited. This study compared implant survivorship and clinical outcomes among affected and unaffected limbs in patients with sequelae of poliomyelitis undergoing TKAs.MethodsA retrospective review of our total joint registry identified 94 patients with post-polio syndrome undergoing 116 primary TKAs between January 2000 and December 2019. The mean age was 70 years (33 to 86) with 56% males (n = 65) and a mean BMI of 31 kg/m2 (18 to 49). Rotating hinge TKAs were used in 14 of 63 affected limbs (22%), but not in any of the 53 unaffected limbs. Kaplan-Meier survivorship analyses were completed. The mean follow-up was eight years (2 to 19).ResultsThe ten-year survivorship free from revision was 91% (95% confidence interval (CI) 81 to 100) in affected and 84% (95% CI 68 to 100) in unaffected limbs. There were six revisions in affected limbs: three for periprosthetic femoral fractures and one each for periprosthetic joint infection (PJI), patellar clunk syndrome, and instability. Unaffected limbs were revised in four cases: two for instability and one each for PJI and tibial component loosening. The ten-year survivorship free from any reoperation was 86% (95% CI 75 to 97) and 80% (95% CI 64 to 99) in affected and unaffected limbs, respectively. There were three additional reoperations among affected and two in unaffected limbs. There were 12 nonoperative complications, including four periprosthetic fractures. Arthrofibrosis occurred in five affected (8%) and two unaffected limbs (4%). Postoperative range of motion decreased with 31% achieving less than 90° knee flexion by five years.ConclusionTKAs in post-polio patients are complex cases associated with instability, and one in four require constraint on the affected side. Periprosthetic fracture was the main mode of failure. Arthrofibrosis rates were high and twice as frequent in affected limbs.Cite this article: Bone Joint J 2023;105-B(6):635–640.

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“…this has been reported over the last two decades in scotland, with more than double the number of revision tkas performed, 5 consistent with data from the usa. 6 a hinge knee arthroplasty (hka) is one of the implant options for revision tka, 7 but is a constrained device with increased torsional load. this load is transmitted to the bone implant interface and may be associated with early loosening and increased risk of revision.…”

Section: Introductionmentioning

confidence: 99%

“…A hinge knee arthroplasty (HKA) is one of the implant options for revision TKA, 7 but is a constrained device with increased torsional load. This load is transmitted to the bone implant interface and may be associated with early loosening and increased risk of revision.…”

Section: Introductionmentioning

confidence: 99%

First-time revision knee arthroplasty using a hinged prosthesis

Clement

Avery

Mason

et al. 2023

The Bone & Joint Journal

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Aims The aim of this study was to identify variables associated with time to revision, demographic details associated with revision indication, and type of prosthesis employed, and to describe the survival of hinge knee arthroplasty (HKA) when used for first-time knee revision surgery and factors that were associated with re-revision. Methods Patient demographic details, BMI, American Society of Anesthesiologists (ASA) grade, indication for revision, surgical approach, surgeon grade, implant type (fixed and rotating), time of revision from primary implantation, and re-revision if undertaken were obtained from the National Joint Registry data for England, Wales, Northern Ireland, and the Isle of Man over an 18-year period (2003 to 2021). Results There were 3,855 patient episodes analyzed with a median age of 73 years (interquartile range (IQR) 66 to 80), and the majority were female (n = 2,480, 64.3%). The median time to revision from primary knee arthroplasty was 1,219 days (IQR 579 to 2,422). Younger age (p < 0.001), decreasing ASA grade (p < 0.001), and indications for revision of sepsis (p < 0.001), unexplained pain (p < 0.001), non-polyethylene wear (p < 0.001), and malalignment (p < 0.001) were all associated with an earlier time to revision from primary implantation. The median follow-up was 4.56 years (range 0.00 to 17.52), during which there were 410 re-revisions. The overall unadjusted probability of re-revision for all revision HKAs at one, five, and ten years after surgery were 2.7% (95% confidence interval (CI) 2.2 to 3.3), 10.7% (95% CI 9.6 to 11.9), and 16.2% (95% CI 14.5 to 17.9), respectively. Male sex (p < 0.001), younger age (p < 0.001), revision for septic indications (p < 0.001) or implant fracture (p = 0.010), a fixed hinge (p < 0.001), or surgery performed by a non-consultant grade (p = 0.023) were independently associated with an increased risk of re-revision. Conclusion There were several factors associated with time to first revision. The re-revision rate was 16.2% at ten years; however, the risk factors associated with an increased risk of re-revision could be used to counsel patients regarding their outcome. Cite this article: Bone Joint J 2023;105-B(1):47–55.

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High ten-year implant survivorship and low patellofemoral complication rate for S-ROM rotating-hinge implants in revision total knee arthroplasty

Cited by 6 publications

References 30 publications

Satisfactory medium- to long-term outcomes of cemented rotating hinge prosthesis in revision total knee arthroplasty

Satisfactory medium- to long-term outcomes of cemented rotating hinge prosthesis in revision total knee arthroplasty

Primary total knee arthroplasty in patients with post-polio syndrome

First-time revision knee arthroplasty using a hinged prosthesis

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