The SMILES prosthesis in salvage revision knee surgery

Complex total knee arthroplasty using resection prostheses at mid-term follow-up

“…The increasing number of difficult revision cases has led to the development of implant systems that provide a solution for the surgeon when he is confronted with these deficiencies at the same time [6][7][8][9][10][11][12][13][14]. These systems have been used in the past for artificial reconstruction of the knee joint after radical bone and/or soft tissue resection for tumour cases in or around the knee [15][16][17].…”

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

“…Different surgical reconstruction methods, such as allograft augmentation for large bone defects, different types of arthrodesis, or even amputations have been described in small series for these exceptionally demanding cases [3,[10][11][12][13][14]. Modular-hinged implants provide the opportunity of bridging large bone defects and restoring a stable joint situation even when stabilizing ligaments structures have been lost in prior operations [15][16][17]. Availability and modularity are key factors for the use of these implants and its advantage in comparison with other techniques.…”

“…No statistically significant difference has been observed between septic and aseptic KRI indication (p = 0.84) Arch Orthop Trauma Surg in accordance to our findings, the importance of comorbidities and the patient's age as factors negatively influencing reinfection rates. Furthermore, Back et al report of 10 % infections in a series of 29 patients after knee salvage using the custom made rotating-hinge SMILES Ò (Stanmore Modular Individualized Lower Extremity System; Stanmore Implants Worldwide, Stanmore, UK) knee revision implant leading to one amputation [15]. Sanguineti et al observed one (20 %) reinfection out of five patients treated with the Endo-Model rotating-hinge revision knee after septic indication [23].…”

Augmentation in Primary Total Knee Arthroplasty, is it Essential?

“…Long-term followup studies indicate a survival rate of at least 90% within 15 years [1,2]. Primary total knee arthroplasty (TKA) using modern implants results in more than 95% good to excellent results [3].…”