Knee salvage in revision arthroplasty after massive bone loss of the femur condyles (≥Engh III) with a single-modular-hinged knee revision implant

Abstract

In consideration of this complex study, population acceptable functional results can be achieved using a modular knee revision endoprosthesis. In younger patients (<60 years), satisfying results in terms of walking ability and overall satisfactory can be expected. The outcome in older multimorbid patients is worse. Yet, operation in these patients can be feasible to restore enough mobility for daily household activities.

Complications and failures of non-tumoral hinged total knee arthroplasty in primary and aseptic revision surgery: A review of 290 cases

“…These findings are also consistent with the literature [11,17,23,27,[30][31][32]41,45,46]. Periprosthetic fractures are rarer but mainly occurred in the femur and always required re-operation as described in the literature [10,16,17,25,30,31,[41][42][43][44][45][46]. General complications were not very common in our study, while their incidence varies greatly in the literature (Table 1) [10,16,17,27,28,30,31,41,45,53].…”

“…Aseptic loosening made up 8% of the complications (23 patients), which is consistent with other published studies in which the loosening ranged from 1% to 13% [19,28,29,33,[42][43][44][45]49]. We included the loosening cases that were not reoperated on (Ewald's radiographic criteria [36]), which may increase the incidence of this complication relative to other studies where surgical revision was the only criterion for labelling loosening as a complication [28,29,33,42,44]. We noticed that aseptic loosening is mainly observed in the subset of patients who were undergoing revision surgery, and mainly occurred at the femur.…”

“…The infection rate in our study (11%; 32 patients) appears to be in the average of the literature [10,11,16,19,24,26,27,29,[31][32][33][42][43][44][45][46][47][48][49]. This complication always requires surgical treatment except if a major contraindication exists.…”

“…2, 3 and Table 4). The surgical revision and fracture subsets had a higher complication rate, which can be explained by the patients' worse overall health, unfavorable conditions around the knee and complexity of the surgical procedure [7][8][9][10][11][12][13]21,42,46,53,56]. In the primary TKA subset, the high rate of infection and mortality is a reminder of the specific predispositions for these patients: either local ones such multiple ligament lesions, considerable knee laxity, large deformity or multiple prior surgeries or in patients who have systemic diseases such as inflammatory arthropathy that involve long-term immunosuppressant therapy [22,24,26,40,41,55,57].…”