Rotating Hinge Implants in Knee Arthroplasty

Abstract

Due to demographic transition an increasing number of primary knee arthroplasty is expected. A consequence is a rise in frequency in revision knee arthroplasty. Rotating hinge prostheses are a development of former hinge prostheses, due to changes in implant design the outcome of modern rotating hinge implants clearly improved in comparison to former models. Interpretation of outcome in present literature is difficult due to the small number of cases and the heterogeneous indications. Nevertheless the use of rotating hinge knee prostheses in primary and revision arthroplasty is associated with good clinical outcomes, when indicated appropriately.

Rotating Hinge Prosthesis for Primary and Revision Knee Arthroplasty: Comparison and Indications

“…After the initial experience of a rather high number of revisions due to patella problems, the share of interventions including patella resurfacing increased, and revisions due to patella problems were reduced. A similar trend of increasing use of a patella component in primary TKA can also be observed in the EPRD and NJRR [ 6 , 7 ], whereas the Swedish joint registry recorded decreasing rates of patellar resurfacing [ 13 ]. The issue with patella problems demonstrates the impact of a learning curve regarding the application of a new implant system, which we also recognized in our experience with this prothesis.…”

“…Current “Third generation” rotating hinge prostheses also allow axial rotation and distraction. Femoral and tibial components are typically fixed by an intramedullary stem, and elements to compensate bony defects may be added [ 6 – 9 ].…”