Rotating Hinged Total Knee Replacement
| Autor: | Nicholas Slenker, James J. Purtill, Aidin Eslam Pour, Javad Parvizi, Peter F. Sharkey |
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| Rok vydání: | 2007 |
| Předmět: |
Male
Reoperation medicine.medical_specialty medicine.medical_treatment Radiography Total knee arthroplasty Periprosthetic Prosthesis Design Prosthesis medicine Humans Orthopedics and Sports Medicine Prospective Studies Range of Motion Articular Arthroplasty Replacement Knee Reduction (orthopedic surgery) Aged Aged 80 and over business.industry Patient Selection General Medicine Middle Aged medicine.disease Surgery Survival Rate Osteopenia Treatment Outcome Orthopedic surgery Cohort Female Knee Prosthesis business |
| Zdroj: | The Journal of Bone and Joint Surgery-American Volume. 89:1735-1741 |
| ISSN: | 0021-9355 |
| DOI: | 10.2106/00004623-200708000-00010 |
| Popis: | Background: A rotating hinged total knee prosthesis may be utilized for the treatment of global instability or severe bone loss around the knee. Older generations of rotating hinged designs were associated with suboptimal outcomes. We evaluated the outcome of salvage knee reconstructions that had been performed with use of modern-generation modular segmental kinematic rotating hinged total knee prostheses. Methods: The cohort included forty-three patients (twenty-nine women and fourteen men) who underwent forty-four knee arthroplasties for the treatment of a non-neoplastic condition with use of a modern-generation kinematic rotating hinged prosthesis. Revision of a previous total knee arthroplasty in the presence of massive bone loss was the most common indication for surgery. Complete clinical and radiographic data were collected for all patients after a mean duration of follow-up of 4.2 years. Results: Reconstruction with a rotating hinged total knee prosthesis provided substantial improvement in function and reduction in pain. However, a relatively large number of complications and failures (including revision because of periprosthetic infection [three knees], aseptic loosening [four], and periprosthetic fracture [one]) were encountered, with a mean time to failure of 1.7 years. The rate of prosthetic survival was 79.6% at one year and 68.2% at five years with revision or reoperation as the end point. Conclusions: The present study highlights the commonly held opinion that a modular kinematic rotating hinged total knee prosthesis has a role for salvage reconstruction of the knee. In light of the relatively high rate of complications, we believe that this salvage procedure should be reserved primarily for elderly and sedentary patients. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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