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Midterm results of modular hinge total knee arthroplasty using cementless osseointegrating stems: low fixation associated complications and good functional outcome in primary and revision knee arthroplasty

  • Knee Revision Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to investigate functional outcome and complications after primary and revision modular H-TKA using hybrid fixation with cementless stems.

Methods

Between 2015 and 2018, 48 patients with 50 implants were included after hybrid implantation of a single design H-TKA system using cementless osseointegrating stems and modular components. Complications and clinical outcome were analysed using Knee Society Score (KSS), the Western Ontario McMasters Universities Osteoarthritis Index (WOMAC) and the Short-Form Health Survey 12 (SF-12) score.

Results

Indications for implantation were aseptic revision (n = 29, 58%), primary TKA (n = 19, 38%) and two-stage septic revisions (n = 2, 4%). Complications were reported in 26% (n = 12), whereas complications associated with hybrid fixation occurred in 5 (10%) cases, with 2 (4%) requiring revision surgery for aseptic loosening and 3 (6%) treated with an adapted postoperative protocol for perioperative fractures. Implant survivorship was 84% after a mean follow-up of 54 months. Postoperative KSS significantly improved from 51.50 (12–100) to 78.36 (41–99; p < 0.001). The mean WOMAC score was 19.26 (0–55), SF-12 PCS was 41.56 points (22.67–57.66) and SF-12 MCS was 49.21 points (23.87–63.21).

Conclusion

Hybrid modular implantation in H-TKA provides satisfactory clinical and functional results in primary and revision TKA. Clinical outcomes significantly improve with reduced pain, increased mobility, and good-to-excellent functional scores after implantation. Whilst implant survival is comparable to previous studies and complications associated with hybrid fixation are low, general complication rates are comparably high.

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Data availability

Raw data for this study are not publicly available to preserve individuals’ privacy under the European General Data Protection Regulation.

Abbreviations

AORI:

Anderson Orthopaedic Research Institute

H-TKA:

Hinge total knee arthroplasty

KSS:

Knee Society Score

PJI:

Periprosthetic joint infection

PMMA:

Polymethyl methacrylate

PROMS:

Patient-reported outcome measures

ROM:

Range of motion

SF-12:

Short-Form Health Survey 12

SF-12 MCS:

SF-12 mental component score

SF-12 PCS:

SF-12 physical component score

TiN:

Titanium nitride coating

TKA:

Total knee arthroplasty

WOMAC:

Western Ontario McMasters Universities Osteoarthritis Index

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Funding

The authors declare that no funds, grants, or other support was received during the preparation of this manuscript. Study is based on institutional review board (IRB) approval. Study is part of thesis of Line Hofmann.

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Authors and Affiliations

  1. Department of Trauma and Orthopedic Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Friedberger Landstr. 430, 60389, Frankfurt am Main, Germany

    M. Schnetz, L. Hofmann, L. Ewald, A. Klug, R. Hoffmann & Y. Gramlich

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  1. M. Schnetz
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  2. L. Hofmann
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  3. L. Ewald
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  4. A. Klug
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Correspondence to M. Schnetz.

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Schnetz, M., Hofmann, L., Ewald, L. et al. Midterm results of modular hinge total knee arthroplasty using cementless osseointegrating stems: low fixation associated complications and good functional outcome in primary and revision knee arthroplasty. Arch Orthop Trauma Surg 144, 831–845 (2024). https://doi.org/10.1007/s00402-023-05148-7

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  • DOI: https://doi.org/10.1007/s00402-023-05148-7

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