The use of a modular rotating hinge component in salvage revision total knee arthroplasty

Barrack, Robert L.; Lyons, Thomas R.; Ingraham, Robert; Johnson, Joel O.

doi:10.1054/arth.2000.9056

Cited by 117 publications

(87 citation statements)

References 27 publications

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“…There were observably significant difference between preoperative and postoperative knee and function scores and motion. We also found a temporal trend that more recently published studies reported higher mean postoperative global rating scale scores [1,2,4]. This temporal relationship may represent technology improvement in prosthetic design, surgical techniques, patient selection, or postoperative management.…”

Section: Discussionsupporting

confidence: 77%

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Patient outcome following revision total knee arthroplasty: a meta-analysis

Sheng

Lehto

Kataja

et al. 2004

International Orthopaedics

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The purpose of this study was to summarize the literature describing patient outcome following revision total knee arthroplasty. Original studies were included if they were published between 1990 and 2002, enrolled ten or more patients, and measured patient outcome using a global knee rating scale. We found 33 studies with a total number of 1,356 patients. There were 429 men and 611 women with a mean age of 67 (45-90) years. The weighted mean follow-up time was 57 (6-108) months. The main indication of revision was loosening. The weighted mean preoperative and postoperative knee scores were 49 (15-82) and 84 (58-109) respectively. There were significant differences between preoperative and postoperative knee and function scores and motion (knee: t=12.507 p<0.001, function: t=4.704 p<0.001, motion: t=5.346 p<0.001). Loosening was also the main complication after revision surgery. In this analysis, revision total knee arthroplasty was a safe and effective procedure.

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Section: Discussionsupporting

confidence: 77%

“…Because some articles lacked the number of patients' gender [1,3,5,6,7,8,9], there were 429 men and 611 women with the weighted mean age of 67 (range 45-90) years. The studies reported outcomes on a mean of 41 (median 34) patients.…”

Section: Patient Characteristicsmentioning

confidence: 99%

Patient outcome following revision total knee arthroplasty: a meta-analysis

Sheng

Lehto

Kataja

et al. 2004

International Orthopaedics

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“…This would reduce the lever arm of the extensor mechanism and result in higher quadriceps muscle force required to extend the knee (Ostermeier et al 2004). It has been recommended that hinged prostheses be used in cases of severe knee instability (Barrack 2001(Barrack , 2002. With this increased stabil-ity and minimized paradoxical movement due to the hinge mechanism, a mechanical improvement of the quadriceps lever arm could be postulated.…”

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confidence: 99%

Quadriceps force during knee extension after non-hinged and hinged TKA: An in vitro study

Ostermeier

Friesecke²,

Fricke

et al. 2008

Acta Orthopaedica

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Background and purpose Problems during knee extension, due to kinematic alterations, are not uncommon after total knee arthroplasty. Hinged prostheses provide higher stability than non-hinged designs and may minimize these alterations. Thus, in this in vitro study we investigated the quadriceps force required to extend the knee during an isokinetic extension cycle generating a constant extension moment after non-hinged and hinged total knee arthroplasty.Methods Human knee specimens were tested in a kinematic knee simulator under physiological conditions, after implantation of two types of non-hinged cruciate retaining prosthesis (Gemini; Link, Germany and Interax I.S.A.; Stryker, Ireland) and a hinged prosthesis (Rotations-Knie; Link, Germany). During simulation of an extension cycle from 120° knee flexion to full extension, the change in quadriceps force to produce the constant extension moment of 31 Nm was dynamically measured using a load cell attached to the quadriceps tendon.Results After implantation of the non-hinged prostheses, there was no alteration in maximum quadriceps force in knee flexion compared to physiological conditions, but alteration occurred at lower flexion angle (p = 0.002) and increased up to 1,257 (SD 273) N (p = 0.04) in knee extension. Following implantation of the hinged prosthesis, there was no alteration in quadriceps extension force in flexion but it decreased to 690 (SD 81) N (p = 0.003) in extension.Interpretation Hinged knee prostheses restore the quadriceps lever arm in knee flexion and improve the

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“…Despite reports of reduced pain and improved ROM, Knee Society scores, and patient satisfaction after the use of modern-generation rotatinghinge prostheses in complex revision situations [1,6], medium-and long-term followup is limited [2,6,9,13,14,16] and some authors continue to report complications and failures related to aseptic loosening, infection, and periprosthetic fracture with these devices [14,19]. None of these described failures of the hinge mechanism.…”

Section: Introductionmentioning

confidence: 99%

Case Report: Failure of Rotating-hinge Total Knee Prosthesis by Disengagement of the Hinge-post Extension

Biswas

Haughom

Mayle

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Although modern-generation rotating-hinge knee implants have been modified to mitigate earlier complications related to aseptic loosening with these devices in revision TKAs, there are few, if any, reports of failure related to the hinge mechanism in these prostheses. Case Description We present a case of disengagement of the hinge-post extension in a contemporary rotating-hinge knee prosthesis originally implanted during revision surgery for instability and extensor mechanism insufficiency. We hypothesize the screw home kinematics of the knee resulted in a counterclockwise torque, contributing to the hinge post locking screw disengagement in this case. Literature Review Although some authors have reported complications and failures related to aseptic loosening with rotating-hinge knee prostheses, there have been no reports regarding complications related to the hinge mechanism, which simultaneously links and permits rotation between the femoral and tibial components. Clinical Relevance Arthroplasty surgeons who use rotating-hinge knee prostheses need to be aware of this potential mode of failure. Design modifications, including more secure locking mechanisms and side-specific implants, may avoid this complication.

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The use of a modular rotating hinge component in salvage revision total knee arthroplasty

Cited by 117 publications

References 27 publications

Patient outcome following revision total knee arthroplasty: a meta-analysis

Patient outcome following revision total knee arthroplasty: a meta-analysis

Quadriceps force during knee extension after non-hinged and hinged TKA: An in vitro study

Case Report: Failure of Rotating-hinge Total Knee Prosthesis by Disengagement of the Hinge-post Extension

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