STANMORE MODULAR INDIVIDUALISED LOWER EXTREMITY SYSTEM (SMILES): ROTATING HINGE KNEE PROSTHESIS IN PRIMARY ARTHROPLASTY: UP TO 17 YEAR FOLLOW UP.

Bayliss L, Gikas P, Hanna S, et al. STANMORE MODULAR INDIVIDUALISED LOWER EXTREMITY SYSTEM (SMILES): ROTATING HINGE KNEE PROSTHESIS IN PRIMARY ARTHROPLASTY: UP TO 17 YEAR FOLLOW UP.. Orthop Procs. 2009;91-B(SUPP_III):409-410. doi:10.1302/0301-620X.91BSUPP_III.0910409d

Bayliss, L, et al. “STANMORE MODULAR INDIVIDUALISED LOWER EXTREMITY SYSTEM (SMILES): ROTATING HINGE KNEE PROSTHESIS IN PRIMARY ARTHROPLASTY: UP TO 17 YEAR FOLLOW UP..” Orthopaedic Proceedings, vol. 91-B, no. SUPP_III, 2009, pp. 409-410., https://doi.org/10.1302/0301-620X.91BSUPP_III.0910409d

Bayliss, L., Gikas, P., Hanna, S., David, L., Aston, W., Carrington, R., Skinner, J., Cannon, S., & Briggs, T. (2009). STANMORE MODULAR INDIVIDUALISED LOWER EXTREMITY SYSTEM (SMILES): ROTATING HINGE KNEE PROSTHESIS IN PRIMARY ARTHROPLASTY: UP TO 17 YEAR FOLLOW UP.. Orthopaedic Proceedings, 91-B(SUPP_III), 409-410. https://doi.org/10.1302/0301-620X.91BSUPP_III.0910409d

Bayliss, L., Gikas, P., Hanna, S., David, L., Aston, W., Carrington, R. et al. (2009) “STANMORE MODULAR INDIVIDUALISED LOWER EXTREMITY SYSTEM (SMILES): ROTATING HINGE KNEE PROSTHESIS IN PRIMARY ARTHROPLASTY: UP TO 17 YEAR FOLLOW UP..” Orthopaedic Proceedings, 91-B(SUPP_III), pp. 409-410. Available at: https://doi.org/10.1302/0301-620X.91BSUPP_III.0910409d

Bayliss, L, P Gikas, SA Hanna, LA David, W Aston, R Carrington, J Skinner, SR Cannon, and TWR Briggs. “STANMORE MODULAR INDIVIDUALISED LOWER EXTREMITY SYSTEM (SMILES): ROTATING HINGE KNEE PROSTHESIS IN PRIMARY ARTHROPLASTY: UP TO 17 YEAR FOLLOW UP..” Orthopaedic Proceedings 91-B, no. SUPP_III (2009): 409-410. https://doi.org/10.1302/0301-620X.91BSUPP_III.0910409d

Bayliss L, Gikas P, Hanna S, David L, Aston W, Carrington R, et al. STANMORE MODULAR INDIVIDUALISED LOWER EXTREMITY SYSTEM (SMILES): ROTATING HINGE KNEE PROSTHESIS IN PRIMARY ARTHROPLASTY: UP TO 17 YEAR FOLLOW UP.. Orthop Procs. 2009 Sep 1;91-B(SUPP_III):409-410. https://doi.org/10.1302/0301-620X.91BSUPP_III.0910409d

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Abstract

Introduction: We report our experience with use of the SMILES prosthesis in primary knee arthroplasty.

Methods: The Stanmore Modular Individualised Lower Extremity System (SMILES prosthesis) has been shown to be effective in complex revision knee surgery. It incorporates a rotating hinge platform knee joint and can overcome the major problems of bone loss and ligamentous laxity.

38 patients (41 knees) who received a primary SMILES knee prosthesis by one of the senior authors between 1990 and 2006 were retrospectively studied. Knee function was assessed pre and post-operatively using the Oxford knee score (0–48 scoring system) and the Knee Society Score. Patients receiving surgery for tumours were excluded. The main indications for primary SMILES were bone loss and ligamentous laxity.

Results: The minimum follow-up was 18 months with a mean of 5 years (1–17). The mean age of the patients was 57.7 years (23–86); 15 of the patients were male. The indications for surgery were trauma (12), osteoarthritis with deficient medial collateral ligament (8), polio (7), rheumatoid arthritis (5), epiphyseal dysplasia (4), achondroplasia (2), avascular necrosis (1), osteogenesis imperfecta (1) and ankylosing spondylitis (1).

2 patients died and 5 were lost to follow-up. 2 patients required revision surgery (one for infection and one for re-bushing). Post-operative complications included peroneal nerve palsy (1) and DVT (1). The mean Oxford knee score improved from 9 pre-op to 44 post-op, and the mean knee society score improved from 24 pre-op to 71 post-op. The average range of motion was 57 degrees pre-op and 88 degrees post-op.

Conclusion: We conclude that the SMILES prosthesis offers significant improvement in clinician and patient assessed outcome scores in complex primary knee arthroplasty. The cost compares favourably with other designs and its use is well established.

Correspondence should be addressed to Mr T Wilton, c/o BOA, BASK at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England.