Management of Gonarthrosis with a Rotating Hinge Prosthesis: Minimum 10-Year Follow-up.
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Knee
/ instrumentation
Female
Follow-Up Studies
Humans
Knee Prosthesis
Male
Middle Aged
Osteoarthritis, Knee
/ surgery
Prosthesis Design
Prosthesis Failure
Reoperation
/ statistics & numerical data
Retrospective Studies
Surveys and Questionnaires
Deformity
Hinge
Knee replacement
Rotating hinge
Valgus
Journal
Clinics in orthopedic surgery
ISSN: 2005-4408
Titre abrégé: Clin Orthop Surg
Pays: Korea (South)
ID NLM: 101505087
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
05
11
2019
accepted:
31
03
2020
entrez:
4
12
2020
pubmed:
5
12
2020
medline:
1
9
2021
Statut:
ppublish
Résumé
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. 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. 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%. 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.
Sections du résumé
BACKGROUND
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
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
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
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.
Identifiants
pubmed: 33274023
doi: 10.4055/cios19153
pmc: PMC7683197
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
464-469Informations de copyright
Copyright © 2020 by The Korean Orthopaedic Association.
Déclaration de conflit d'intérêts
CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported.
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