Is There a Place for Rotating-Hinge Arthroplasty in Knee Revision Surgery for Aseptic Loosening?

Joshi, Nayana; Navarro-Quilis, Antonio

doi:10.1016/j.arth.2007.10.016

Cited by 87 publications

(59 citation statements)

References 31 publications

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“…16,[22][23][24][25][26][27][28][29] Its use in the trauma setting has yet to be published. The prosthesis has antitorsional, antitilt and antimigration properties.…”

Section: Description Of Surgical Technique and Patient Managementmentioning

confidence: 99%

A 3 year minimum follow up of Endoprosthetic replacement for distal femoral fractures — An alternative treatment option

Atrey

Hussain²,

Gosling³

et al. 2017

Journal of Orthopaedics

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Introduction: Although the use of an endoprosthesis for distal femoral fractures remains a valid treatment option the widespread use is in its infancy. Methodology: In this retrospective case series, we review cases of distal femoral fracture treated with endoprosthetic replacement (EPR). The outcomes we assessed were the time to start mobilising, the time to discharge, morbidity and mortality as well as an Oxford knee score to assess pain and function and also the early survivorship. 6 of the 11 from the cohort had existing Total Knee Replacements (TKRs) in situ. Results: There were 11 knees in our cohort with a mean age of 81.5 years (range 52-102 years). The median time to follow up was 3.5 years (range 1.6 to 5.5 years). The median times to theatre was 3 days and to discharge was 16 days. Oxford functional and pain scores were 32/48. Discussion: In the appropriate patient and fracture pattern, Endoprosthetic knee replacement is an excellent option in the treatment of distal femoral fractures whether associated with an existing TKR or not. The implant is more costly than traditional open reduction and internal fixation, but the earlier return to full mobility post-operatively may save on hospital/care home stay and free up hospital space and minimise complications.

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“…16,[22][23][24][25][26][27][28][29] Its use in the trauma setting has yet to be published. The prosthesis has antitorsional, antitilt and antimigration properties.…”

Section: Description Of Surgical Technique and Patient Managementmentioning

confidence: 99%

A 3 year minimum follow up of Endoprosthetic replacement for distal femoral fractures — An alternative treatment option

Atrey

Hussain²,

Gosling³

et al. 2017

Journal of Orthopaedics

View full text Add to dashboard Cite

show abstract

“…The clinical results, ROM, and satisfaction were comparable to those of a standard condylar revision knee arthroplasty, despite the fact that the cases were more complex. Joshi and Navarro-Quilis [10] reviewed the results of 78 revision TKAs using a rotating-hinge device in patients requiring revision arthroplasty due to aseptic loosening. Fifty-seven patients showed excellent results, with a ROM of 104°in flexion and complete extension, better than our results.…”

Section: Discussionmentioning

confidence: 99%

Hinged Total Knee Arthroplasty in the Presence of Ligamentous Deficiency

Hernández-Vaquero

Sandoval-García

2010

Clinical Orthopaedics &Amp; Related Research

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Background Rotating-hinge total knee prostheses may be used for the treatment of global instability about the knee. The designs of previous generations were associated with suboptimal outcomes. Questions/purposes We evaluated the clinical and radiographic outcomes of salvage knee reconstructions using modern-generation, modular, kinematic rotating-hinge total knee prostheses. Methods We retrospectively reviewed 26 rotating-hinge arthroplasty devices to examine whether acceptable results were obtainable using a single arthroplasty design. The average age of the patients was 77 years (SD, 9 years); the minimum followup was 24 months (mean, 46 months; range, 24-107 months). The indication was revision surgery in 21 patients and complex primary surgery in five.

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“…Numerous authors have reported improvements in pain and function [2,9,10,13] and ROM [10,15] after the use of rotating-hinge prostheses. 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].…”

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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Is There a Place for Rotating-Hinge Arthroplasty in Knee Revision Surgery for Aseptic Loosening?

Cited by 87 publications

References 31 publications

A 3 year minimum follow up of Endoprosthetic replacement for distal femoral fractures — An alternative treatment option

A 3 year minimum follow up of Endoprosthetic replacement for distal femoral fractures — An alternative treatment option

Hinged Total Knee Arthroplasty in the Presence of Ligamentous Deficiency

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

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