The Kinematic Rotating Hinge: Biomechanics and Clinical Application

Walker, Peter S.; Emerson, Roger H.; Potter, Theodore A.; Scott, Richard D.; Thomas, William H.; Turner, Richard B.

doi:10.1016/s0030-5898(20)30276-5

Cited by 74 publications

(17 citation statements)

References 13 publications

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“…A second generation of hinged prostheses followed with design modifications that decreased prosthetic constraint by including axial rotation and varus/valgus motion of the hinge. [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] These less constrained designs include the Sheehan, Herbert, Attenborough, Spherocentric, Noiles, and Kinematic rotating hinge prostheses. Like their first-generation counterparts, some early secondgeneration prostheses suffered unacceptable complication rates and early failure.…”

Section: Historymentioning

confidence: 99%

“…The mid-to late-term outcomes were more disappointing. [22][23][24][25][26][27][28][29][30][31][32][33] As a whole, the second generation of hinged knee designs were a clinical improvement over the first generation, but unacceptably high failure rates and numerous complications continued. 34 In general, these second-generation implants are no longer used.…”

Section: Historymentioning

confidence: 99%

“…As a whole, the design modifications associated with the second generation of hinged knee implants may be summarized as the inclusion of varus/valgus motion and modest axial rotation to a linked design. [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]…”

Section: Second-generation Implantsmentioning

confidence: 99%

“…29 The prosthetic linkage controls 2 of 3 degrees of linear freedom, while the soft tissue sleeve limits distraction. 29,30 The prosthesis also controls varus-valgus motion, while allowing flexion-extension and axial rotation. The limits of flexion are related more to soft tissue restraints than to prosthetic design.…”

Section: Kinematicmentioning

confidence: 99%

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Hinge Implants

Manning¹,

Chiang²,

Freiberg³

Revision Total Knee Arthroplasty

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T he origin of knee arthroplasty can be traced to 1863 and Vernuil's attempt to relieve arthritic knee pain through the surgical interposition of joint capsule.1 Soft tissue substrates such as muscle, fat, fascia, and pig bladder were later used. However, the outcomes of each were equally as unsatisfactory as Vernuil's original procedure. Eventually biologic or tissue arthroplasty substrates were abandoned in favor of acrylics and metal alloys in the form of a hinge.1 The constraint to motion inherent in the hinge design was thought necessary to allow a stable physiologic range of motion and prevent dislocation of the prosthetic joint.2 Like soft tissue arthroplasty, the clinical results of early, hinged prosthesis were poor. Prosthetic loosening, fracture, and deep infection were common. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Newer generations of the hinge design were developed to combat perceived design flaws but met with little success. Continued poor results led to disfavor of the hinge design, and the adoption of newer, more successful, unlinked arthroplasty designs. As total knee arthroplasty has expanded, specific indications for both an unconstrained and a highly constrained arthroplasty design have become apparent, and the development and evolution of the linked hinge prosthesis has continued. Further design modifications include multiple sizing, component modularity, hinge rotation, ingrowth surfaces, polyethylene bearings, and the manufacture of fracture-resistant superalloys. The resultant generation of linked, rotating, hinged prostheses holds promise for improved survivorship in complex knee reconstruction. HISTORYThe first hinged total knee prosthesis was made from acrylic resin and introduced by Walldius in 1951.1 The same design was later produced from stainless steel. Other designs soon followed, such as the Shier's metallic hinge in 1953, Young's Vitallium valgus hinge in 1958, and the Stanmore and Guepar hinges in 1969.1-18 These prostheses, among others, are termed the first generation. The first-generation prostheses were highly constrained, allowing only simple flexion and extension. These highly constrained designs transferred high stresses to the implant-cement-bone interfaces, producing early prosthetic loosening. In addition, the majority of firstgeneration hinges consisted of metal-to-metal articulations and resulted in fretting, fatigue, fracture, and sometimes, dramatic particulate wear debris. Overall, these prostheses were found to have unacceptable complications and early failure rates.A second generation of hinged prostheses followed with design modifications that decreased prosthetic constraint by including axial rotation and varus/valgus motion of the hinge.19-33 These less constrained designs include the Sheehan, Herbert, Attenborough, Spherocentric, Noiles, and Kinematic rotating hinge prostheses. Like their first-generation counterparts, some early secondgeneration prostheses suffered unacceptable complication rates and early failure. The Herbert total k...

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Section: Historymentioning

confidence: 99%

Section: Historymentioning

confidence: 99%

Section: Second-generation Implantsmentioning

confidence: 99%

Section: Kinematicmentioning

confidence: 99%

See 2 more Smart Citations

Hinge Implants

Manning¹,

Chiang²,

Freiberg³

Revision Total Knee Arthroplasty

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“…Il y a actuellement un regain intérêt pour les prothèses à charnières rotatoires pour lesquelles le degré de liberté en rotation diminue les contraintes sur l'articulation et à l'interface os-ciment. Le concept a débuté avec la prothèse « Kinematic Rotating Hinge » ( 19) qui a été beaucoup utilisée dans les deux décennies passées (5, 14,27,33,36,44). Bien que la comparaison des différentes séries soit assez difficile car l'utilisation des prothèses contraintes recouvrent des situations cliniques très variées, la littérature a généralement favorisé les prothèses contraintes sans charnière.…”

Section: La Charnière : Pourquoi Est-ce Si Mauvais ?unclassified

Point de vue : choix de la contrainte dans les changements de prothèses totales du genou

Vince

Malo

La Gonarthrose

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Opinion personnelleL'utilisation d'une prothèse contrainte doit être évitée autant que possible tant qu'une alternative existe. Lorsqu'une contrainte est nécessaire, les prothèses à glissement contraintes doivent être préférées aux prothèses charnières et elle peuvent dans la majorité des cas régler tous les problèmes de stabilité lorsqu'elles sont utilisées de manière appropriée. Par ailleurs l'utilisation d'une contrainte qu'elle quelle soit ne peut en aucun cas s'opposer aux forces liées à un défaut d'alignement. Les prothèses contraintes à charnière ont des design tels qu'elles ne peuvent qu'aggraver la situation sur le long terme. la fixation.

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Limb-sparing surgery for bone tumors: New developments

Choong

Sim

1997

Semin. Surg. Oncol.

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The standard for local control of malignant bone tumors has been amputation. During the last decade, limb‐sparing surgery has been common in the multidisciplinary management of bone sarcoma. Efforts continue toward improving local control of tumor while retaining the function of the reconstructed limb. Major challenges include defining adequate surgical margins and developing biologic and prosthetic reconstructions that match life expectancy. Our review highlights important refinements of earlier techniques, current innovations, and future directions in limb‐salvage surgery. Semin. Surg. Onc. 13:64–69. © 1997 Wiley‐Liss, Inc.

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The Kinematic Rotating Hinge: Biomechanics and Clinical Application

Cited by 74 publications

References 13 publications

Hinge Implants

Hinge Implants

Point de vue : choix de la contrainte dans les changements de prothèses totales du genou

Limb-sparing surgery for bone tumors: New developments

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