Rotating-hinge prosthesis for aseptic revision knee arthroplasty: A multicentre retrospective study of 127 cases with a mean follow-up of five years

Houfani, Fayçal; Mainard, Didier; Rubens-Duval, Brice; Papin, Pierre-Emmanuel; Pasquier, Gilles; Ehlinger, Matthieu

doi:10.1016/j.otsr.2021.102855

Cited by 11 publications

(3 citation statements)

References 45 publications

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“…However, for the survival for revision for any reason a significantly higher risk of revision surgery was seen for rotating hinged prostheses that had been changed to a rotating hinged prosthesis. Axis-guided prostheses generally have higher revision rates, according to the observations of Houfani et al [ 26 ]. In a multicenter study of 127 rotating-hinge prostheses implanted during revision surgery, they found a 5-year survival rate of 77% (95% confidence interval, 0.70–0.85) after a mean observation time of 67.3 ± 11.8 months (range, 13–180 months).…”

Section: Discussionmentioning

confidence: 98%

A Low Rate of Periprosthetic Infections after Aseptic Knee Prosthesis Revision Using Dual-Antibiotic-Impregnated Bone Cement

Blersch,

Barthels,

Schuster

et al. 2023

Antibiotics

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Aim: The incidence of periprosthetic joint infections (PJI) following aseptic knee revision arthroplasty lies between 3% and 7.5%. The aim of this study was to verify the hypothesis that the use of dual-antibiotic-impregnated cement in knee revision arthroplasty leads to a lower rate of periprosthetic joint infections. Methods: We retrospectively reviewed 403 aseptic revision knee arthroplasties performed between January 2013 and March 2021 (148 revisions of a unicompartmental prosthesis, 188 revisions of a bicondylar total knee arthroplasty (TKA), 41 revisions of an axis-guided prosthesis, and 26 revisions of only one component of a surface replacement prosthesis). The bone cement Copal G+C (Heraeus Medical, Wertheim, Germany) with two antibiotics—gentamycin and clindamycin—was used for the fixation of the new implant. The follow-up period was 53.4 ± 27.9 (4.0–115.0) months. Results: Five patients suffered from PJI within follow-up (1.2%). The revision rate for any reason was 8.7%. Survival for any reason was significantly different between the types of revision (p = 0.026, Log-Rank-test), with lower survival rates after more complex surgical procedures. The 5-year survival rate with regard to revision for any reason was 91.3% [88.2–94.4%] and with regard to revision for PJI 98.2% [98.7–99.9%], respectively. Conclusion: The use of the dual-antibiotic-impregnated bone cement Copal G+C results in a lower rate of periprosthetic infections after aseptic knee prosthesis replacement than that reported in published prosthesis revisions using only one antibiotic in the bone cement.

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Section: Discussionmentioning

confidence: 98%

A Low Rate of Periprosthetic Infections after Aseptic Knee Prosthesis Revision Using Dual-Antibiotic-Impregnated Bone Cement

Blersch,

Barthels,

Schuster

et al. 2023

Antibiotics

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“…Several recent studies on rTKA have obtained very large patient cohorts and were able to provide an overview of the addressed issue. However, they admittedly met limitations regarding the variability of implant models and the heterogeneity of certain subgroups, which hindered the data analysis [ 90 , 91 ].…”

Section: Discussionmentioning

confidence: 99%

Etiology of Total Knee Arthroplasty Revisions: A Two-Decade Institutional Perspective

Dragosloveanu,

Petre,

Cretu

et al. 2024

Cureus

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Total knee arthroplasty (TKA) implant survival time is determined by various patient and implant-related factors and varies significantly in recent worldwide reports. In our study, we have included 247 TKA revisions in 203 patients performed in our hospital over the last 20 years. Multiple etiologies of revisions were identified and classified into 10 categories. Time to failure was analyzed with regard to etiology, patient demographics, and other relevant data. The overall average time to revision was 44.08 months (95% confidence interval (CI) between 33.34 and 49.82 months). Age at primary implant was negatively correlated with time to revision (hazard ratio (HR) = 1.0521 and 95% CI of HR = 1.0359 to 1.0685) and female patients showed a 1.59 times higher risk of implant failure than males. Periprosthetic joint infection was the cause of 46.56% (n=115) of revisions (out of which 12.55% (n=31) were early infections, diagnosed within the first three months), while aseptic loosening was found in 31.98% (n=79) of cases. Infection correlated with a shorter time to revision compared to aseptic loosening (p<0.05). These findings emphasize the need to intensify efforts to deliver the best patient care, select the best antibiotic regimen, and improve surgical techniques to decrease the incidence of infectious complications.

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“…Houfani et al [ 7 ] reported in a retrospective study of 127 patients, treated with hinged implants for aseptic loosening, major instability, and mechanical failure, with overall survival at 5 years of 77%. Furthermore, the clinical outcomes evaluated showed improvement in different scores like in the total IKS score (+ 42 points), the IKS function score (+ 12 points), and the knee IKS score (+ 30 points).…”

Section: Discussionmentioning

confidence: 99%

Constraint degree in revision total knee replacement: a registry study on 1432 patients

et al. 2023

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Purpose Total knee replacement (TKR) failure represents a hard challenge for knee surgeons. TKR failure can be managed in revision with different constraint, related with soft and bone knee damages. The choice of the right constraint for every failure cause represents a not summarized entity. The purpose of this study is identifying distribution of different constraints in revision TKR (rTKR) for failure cause and the overall survival. Methods A registry study based on the Emilia Romagna Register of the Orthopaedic Prosthetic Implants (called RIPO) was performed with a selection of 1432 implants, in the period between 2000 and 2019. Selection implants including primary surgery constraint, failure cause and constraint revision for every patient, and divided for constraint degrees used during procedures (Cruciate Retaining-CR, Posterior Stabilized-PS, Condylar Constrained Knee-CCK, Hinged). Results The most common cause of primary TKR failure was aseptic loosening (51,45%), followed by septic loosening (29,12%). Each type of failure was managed with different constraint, the most used was CCK in the most of failure causes, such as to manage aseptic and septic loosening in CR and PS failure. Overall survival of TKA revisions has been calculated at 5 and 10 years for each constraint, with a range of 75.1–90.0% at 5 years and 75.1–87.5% at 10 years. Conclusion Constraint degree in rTKR is typically higher than primary, CCK is the most used constraint in revision surgery with an overall survival of 87.5% at 10 years.

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Rotating-hinge prosthesis for aseptic revision knee arthroplasty: A multicentre retrospective study of 127 cases with a mean follow-up of five years

Cited by 11 publications

References 45 publications

A Low Rate of Periprosthetic Infections after Aseptic Knee Prosthesis Revision Using Dual-Antibiotic-Impregnated Bone Cement

A Low Rate of Periprosthetic Infections after Aseptic Knee Prosthesis Revision Using Dual-Antibiotic-Impregnated Bone Cement

Etiology of Total Knee Arthroplasty Revisions: A Two-Decade Institutional Perspective

Constraint degree in revision total knee replacement: a registry study on 1432 patients

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