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Management of Gonarthrosis with a Rotating Hinge Prosthesis: Minimum 10-Year Follow-up

Clinics in Orthopedic Surgery 2020년 12권 4호 p.464 ~ 469
Kendoff Daniel, Haasper Carl, Gehrke Thorsten, Klauser Wolfgang, Sandiford Nemandra,
소속 상세정보
 ( Kendoff Daniel ) - ENDO-Klinik Orthopaedic Department
 ( Haasper Carl ) - ENDO-Klinik Orthopaedic Department
 ( Gehrke Thorsten ) - ENDO-Klinik Orthopaedic Department
 ( Klauser Wolfgang ) - ENDO-Klinik Orthopaedic Department
 ( Sandiford Nemandra ) - Southland Hospital Joint Reconstruction Unit

Abstract


Background: The use of hinged designs is usually reserved for severe deformities or instability in contemporary total knee arthroplasty (TKA). Results have been mixed with some authors reporting relatively high incidences of complications. The aim of this study is to present the results of primary TKA performed with a hinged prosthesis with a minimum 10-year follow-up. We also examined the factors that influence survivorship of this prosthesis.

Methods: A total of 238 primary TKA procedures were performed using hinged prostheses. Indications included osteoarthritis, rheumatoid arthritis, posttraumatic deformity, and arthritis. Clinical outcomes were assessed using the Hospital for Special Surgery score. Radiologic assessment was performed at each follow-up. Survivorship was calculated based on the Kaplan-Meier method. All complications were documented.

Results: Mean follow-up was 13.5 years (standard deviation [SD], 3.4). Mean flexion at final review was 118° (SD, 20°). Fifty-four percent and 20% reported excellent and good functional scores, respectively. Survivorship was 94% at 13.5 years in patients over 60 years of age and 77% in patients less than 60 years of age. Survivorship in patients with preoperative varus deformity was 96% and that in valgus knees was 79%.

Conclusions: The results of this study suggest that when rotating hinges are used for primary TKA, the best results are achieved in patients over 60 years old. The indications for this design in the setting of primary TKA include significant deformities, severe bone loss, and ligamentous laxity.

키워드

Hinge; Knee replacement; Rotating hinge; Valgus; Deformity

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