Similar outcomes of constrained condylar knee and rotating hinge prosthesis in revision surgery for extension instability after primary total knee arthroplasty

Miralles‐Muñoz, Francisco A.; Pineda-Salazar, Manuel; Rubio-Morales, Marta; González-Parreño, Santiago; Ruiz-Lozano, Matías; Lizaur-Utrilla, Alejandro

doi:10.1016/j.otsr.2022.103265

Cited by 6 publications

(3 citation statements)

References 37 publications

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“…The observed crossover in the survival curve at 6 years, based on implant revision, may be attributed to revisions for aseptic loosening. This pattern is also observed by Miralles-Muñoz et al [5]. Theoretically, an implant with a higher constraint is associated with a higher risk of aseptic loosening [2].…”

Section: Survivorshipsupporting

confidence: 79%

“…Theoretically, an implant with a higher constraint is associated with a higher risk of aseptic loosening [2]. However, the introduction of the newer third‐generation RHK allows more rotational freedom, and therefore reduces the constraint in the axial plane [5]. Consequently, a CCK can lead to more constraint in the axial plane compared to an RHK [18], which is investigated by recent cadaver and biomechanical studies demonstrating that some RHK implants (RT‐Plus RHK [7], Zimmer [23], Endomodel LINK [24]) were prone to less stress shear at the bone–implant interface compared to the CCK implant [7, 23, 24].…”

Section: Discussionmentioning

confidence: 99%

“…Given the rising number of revision arthroplasties, the rationale of this systematic review was to provide an insight into which type of constraint has been associated with the most favourable clinical outcomes and survivorship [4, 5]. In their recent review, Yoon et al focussed solely on 12 comparative studies, 11 of which were non‐randomised.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Condylar constrained and rotating hinged implants in revision knee arthroplasty show similar survivorship and clinical outcome: a systematic review and meta‐analysis

Stroobant,

de Taeye,

Byttebier

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose In revision total knee arthroplasty (TKA) ligament instability and bone defects might require more constraint implants such as a condylar constrained knee (CCK) or rotating hinged knee (RHK). When both implants are suitable, the choice remains controversial. The purpose of this systematic review and meta-analysis was to compare the survivorship and clinical outcome between CCK and RHK in revision TKA. Methods Systematic literature research was performed. Studies analysing the clinical outcome and/or survivorship of CCK and/or RHK in revision TKA were included. Clinical outcomes included the Knee Society Score, both clinical (KSCS) and functional (KSFS), range of motion (ROM) and reoperations. Survival was defined as the time free from removal or revision of the femoral and/or tibial component. Results A total of 40 articles analysing 4.555 knees were included. Survival did not differ between RHK and CCK implants (p = 0.6058), with, respectively, 91.6% and 89.8% survival after 5 years. Postoperative KSCS and KSFS were, respectively, 79.2 (SD 10.7) and 61.1 (SD 21.8) for the CCK group. Similar scores were noted for the RHK group with a KSCS of 80.2 (SD 14.1) and KSFS of 58.5 (SD 17.3). Postoperative ROM was similar for CCK (105.3°, SD 17.1°) and RHK patients (104.1°, SD 16.9°). Conclusion This meta-analysis revealed that both survivorship and clinical outcome are similar for CCK and RHK patients for whom both designs are technically suitable and indicated. Level of evidence IV.

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Section: Survivorshipsupporting

confidence: 79%