Abstract
Introduction
Presentation of our outcome in implant survival and clinical function using rotating-hinge knee prosthesis in revision total knee arthroplasty.
Method
A retrospective review of 44 revision TKA containing 21 RHK (Biomet) and 23 MRH (Stryker).
The patient population consisted of 27 women and 17 men with an average age of 75 years at the time of the revision. The mean follow-up period was 13 months. The clinical and functional results were evaluated according to the Knee-Society-Score (KSS) after 3, 6, 12, 24 and 36 months together with a x-ray.
Results
The indication for the revision included aseptic loosening and ligamentous instability, 6 times as primary total knee replacement, an infected total knee in 6 cases and fractures with severe bone defect in 4 cases.
The KSS pain improved from 49 (range 23–70) to 76 (range 34–98). The KSS function did not show any significant improvement of 60 (range 10–55) to 65 (range 20–100). The ROM improved with 53% from 74 (range 50–110) to 113 (range 65–130).
Our complications have been revisions of hematoma in 4 cases, an infection/recurrence of infection in 2 cases with following explantation. There were 3 ligamentum patellae ruptures, 2 times due to rheumatoid arthritis, once due to Mb. Parkinson. We noticed 2 cases with peronaeus paresis (once temporarily) and one Guillain-Barre-Syndrom.
With our x-rays we observed radiolucent lines without any progression or loosening factor for the prosthesis.
Conclusion
We have seen good results using RHK and MRH in function and particularly a very good stability even for loss of collateral ligaments or massive bone loss. We evaluated a reduction of pain and an improvement of ROM although we had a number of revisions because of infection and co-morbidities.
