Long-term follow-up of the GSB II total knee used in primary total knee arthroplasty

Mid-term survival following primary hinged total knee replacement is good irrespective of the indication for surgery

“…This is most often seen in the revision setting where excessive bone loss, ligamentous laxity and instability, and/or extensor mechanism dysfunction may necessitate an increased level of component constraint [10,14,17,23]. However, this implant type is also being increasingly used in the primary setting [21,2] where it may offer a viable surgical alternative in cases of severe degenerative and inflammatory arthropathy [9,22,24,27,29], osteoporotic intra-articular distal femoral and proximal tibial fractures [4], and neoplastic conditions around the knee unsuited to other implant types [11,19].…”

“…As such information about the behaviour of these implants, particularly when used for primary replacement, is limited. The small number of published case series pertaining to primary hinged knee replacement suggests that these implants produce functional improvements and rates of survival comparable to conventional cemented knee replacements [4,9,11,16,19,20,22,24,[27][28][29]. However, these conclusions are based upon a small number of largely retrospective case series which have reported on primary hinged implants undertaken for a variety of reasons using a wide range of surgical outcome measures [4,9,11,16,19,20,22,24,[27][28][29].…”

“…The small number of published case series pertaining to primary hinged knee replacement suggests that these implants produce functional improvements and rates of survival comparable to conventional cemented knee replacements [4,9,11,16,19,20,22,24,[27][28][29]. However, these conclusions are based upon a small number of largely retrospective case series which have reported on primary hinged implants undertaken for a variety of reasons using a wide range of surgical outcome measures [4,9,11,16,19,20,22,24,[27][28][29]. Furthermore, it could be argued that the heterogeneity of these papers makes it difficult to draw distinct conclusions and have confidence in the expected results when using this type of implant.…”

Current Role of Hinged Implants

“…This often led to extensive wear, and the entire prosthesis had to be exchanged. Therefore, the mid-term results of the GSB prosthesis were also not acceptable [19].…”

Failure in Constraint: "Too Much"

“…Other models added some anterior-posterior translation as a second degree of freedom by linking the femoral and the tibial component with a tibial metal post running in a femoral cam,such as the GSB implant [6].However,this prosthesis yielded unfavorable results after 7.8 years [22].…”