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General Orthopaedics

Rotating hinge knee replacements: a review of the available options, their design characteristics, and suitability for the varied surgical indications

The South African Orthopaedic Association (SAOA) 58th Annual Congress



Abstract

Aim

To analyse the available rotating hinge knee implants available on the market with a view to deriving a rational algorithm for implant selection.

Method

Information on available hinge designs was gathered from the literature and further questionnaires were sent to the relevant implant companies asking for more specific information regarding the minimum bone resection necessary to accommodate the implant, the maximum bone loss that can be compensated with augments, method of transmission of forces, type and size of stems, availability of metaphyseal-filling cones and cost.

Results

Nine available rotating hinge prostheses were investigated and the analysis revealed wide differences in cost, as well as the ability for different systems to cope with varying degrees of bone loss. We have been able to identify important differences in design factors between these prostheses.

Conclusion

Certain prostheses have been identified to be more suitable for particular surgical indications. Based on this work we have devised an algorithm to allow us to select which rotating hinge TKA we use for an individual case, based on: age and activity level of patient, bone loss and cost.

MULTIPLE DISCLOSURES