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Primary total knee arthroplasty using rotating-hinge prosthesis in severely affected knees

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

A rotating-hinge total knee prosthesis may be utilized for the treatment of global instability or severe bone loss around the knee. The outcome of primary total knee arthroplasty (TKA) using Endo-Modell (Link®) rotating-hinge prosthesis was evaluated.

Methods

Retrospectively, review of 50 cases (40 patients) at a mean follow-up of 15 years (range, 10–18) who underwent primary TKA using Endo-Modell (Link®) was performed. Indications included severe primary osteoarthritis with substantial ligament laxity, severe rheumatic arthritis with extreme ligament instability and bone loss, supracondylar nonunion, charcot arthropathy, and posttraumatic arthritis. Knee Society Score (KSS) and radiographic analysis were done for preoperative and at latest follow-up. Statistical analysis was done using the Student’s t test with the level of significance of p < 0.05.

Results

Overall, the rotating-hinge arthroplasty resulted in improved knee functioning. The KSS improved (p < 0.001) from a preoperative mean of 38 ± 14.3 (SD) points to a postoperative mean of 73 ± 12.8 points; the functional score improved (n.s.) from 36 ± 19.5 points to 47 ± 23.5 points. Mean range of motion at the most recent clinical follow-up evaluation was 102 ± 9°. However, all (100%) patients needed some form of assisted devices for walking and a relatively large number of deep infections (14%) were encountered.

Conclusions

Reconstruction with a rotating-hinge total knee prosthesis provided substantial improvement in function and reduction in pain. However, the possibility of assisted walking and high rate of deep infection should be encountered.

Level of evidence

Retrospective therapeutic study, Level IV.

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Acknowledgments

The authors wish to thank Ms. Min-Jung Lee for her assistance with the analysis and statistical assessment of the data. Authors also thank Ms. Hyeran Lee for her assistance with this study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Seoul Veterans Hospital, 6-2 Dunchon Dong, Kangdong Ku, Seoul, Korea

    Jae-Hyuk Yang, Jung-Ro Yoon, Chi-Hun Oh & Taik-Sun Kim

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  1. Jae-Hyuk Yang
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  2. Jung-Ro Yoon
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  3. Chi-Hun Oh
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  4. Taik-Sun Kim
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Correspondence to Taik-Sun Kim.

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Yang, JH., Yoon, JR., Oh, CH. et al. Primary total knee arthroplasty using rotating-hinge prosthesis in severely affected knees. Knee Surg Sports Traumatol Arthrosc 20, 517–523 (2012). https://doi.org/10.1007/s00167-011-1590-1

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  • DOI: https://doi.org/10.1007/s00167-011-1590-1

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