MID-TERM EFFECTIVENESS OF ROTATING HINGE KNEE PROSTHESIS FOR SEVERE KNEE DEFORMITY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZENGMin ,  HUYihe , XIEJie , LIMingqing , LINShaoru

Department of Orthopaedics, Xiangya Hospital of Central South University, Changsha Hunan, 410008, P. R. China;

Corresponding author：

HUYihe, Email: xy_huyh@163.com

Keywords：

Severe knee deformity; Rotating hinge knee prosthesis; Total knee arthroplasty; Mid-term effectiveness

DOI：

10.7507/1002-1892.20140002

Video：

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Objective To evaluate the mid-term effectiveness of rotating hinge knee prosthesis for severe knee deformity. Methods A retrospective analysis was made on the clinical data of 24 patients (24 knees) who received rotating hinge knee prosthesis for total knee arthroplasty between January 2003 and June 2011. There were 14 males and 10 females, aged from 60 to 81 years (mean, 70 years). The disease causes included osteoarthritis in 5 cases, rheumatoid arthritis in 7 cases, traumatic arthritis in 9 cases, and Charcot's arthropathy in 3 cases. The disease duration ranged from 5 to 25 years (mean, 14.5 years). Of them, 13 cases had flexion deformity, 7 cases had valgus deformity, and 16 cases had varus deformity. The operation time, the amount of bleeding between operation and drainage-tubes removal, hospitalization time, incision healing, and complications were recorded. The results were evaluated according to Knee Society Score (KSS), visual analogue scale (VAS), and the range of motion (ROM) of knee. Short-form 36 health survey scale (SF-36) was used to evaluate the life quality of patients. The position of prosthesis was observed through X-ray examination. Results The operation time ranged from 70 to 90 minutes (mean, 78 minutes). The amount of bleeding between operation and drainage-tubes removal ranged from 400 to 1 000 mL (mean, 650 mL). The hospitalization time ranged from 14 to 18 days (mean, 15.2 days). Patellar fracture occurred in 1 case (4.17%) during operation, swelling and effusion of incision in 1 case (4.17%), and periprosthetic infections in 2 cases (8.33%) after operation. All patients were followed up 2-10 years (mean, 5.5 years). The X-ray films showed no evidence of obvious radiolucent line, osteolysis, prosthesis subsidence, and limb alignment change. The results of KSS, VAS socres, and ROM of knee at 1 year postoperatively and last follow-up were significantly better than preoperative ones (P<0.05), but no significant difference was found between at 1 year postoperatively and last follow-up (P>0.05). The physiological function and body pain scores were significantly lower than the reference value of urban men over 60 years old from Sichuan province (t=2.42, P=0.02; t=5.26, P=0.00), but no significant difference was found in the other scores of the SF-36 when compared with the reference value (P>0.05). Conclusion The mid-term effectiveness of total knee arthroplasty using rotating hinge knee for severe knee prosthesis deformity is satisfactory. But complications of postoperative infection should be emphasized.

Citation： ZENGMin, HUYihe, XIEJie, LIMingqing, LINShaoru. MID-TERM EFFECTIVENESS OF ROTATING HINGE KNEE PROSTHESIS FOR SEVERE KNEE DEFORMITY. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(1): 7-12. doi: 10.7507/1002-1892.20140002 Copy

1.	Yang JH,Yoon JR,Oh CH,et al.Primary total knee arthroplasty using rotating-hinge prosthesis in severely affected knees.Knee Surg Sports Traumatol Arthrosc,2012,20(3):517-523.
2.	Hernández-Vaquero D,Sandoval-García MA.Hinged total knee arthroplasty in the presence of ligamentous deficiency.Clin Orthop Relat Res,2010,468(5):1248-1253.
3.	Barrack RL,Lyons TR,Ingraham RQ,et al.The use of a modular rotating hinge component in salvage revision total knee arthroplasty.J Arthroplasty,2000,15(7):858-866.
4.	李宁秀,刘朝杰,李俊,等.四川省城乡居民SF-36评价参考值.华西医科大学学报,2001,32(1):43-47.
5.	Friesenbichler J,Schwarzkopf R,Sadoghi P,et al.Failure rate of a rotating hinge knee design due to yoke fracture of the hinged tibial insert:a retrospective data analysis and review of the literature.Int Orthop,2012,36(5):993-998.
6.	Lozano LM,López V,Ríos J,et al.Better outcomes in severe and morbid obese patients (BMI>35 kg/m²) in primary Endo-Model rotating-hinge total knee arthroplasty.Scientific World Journal,2012,2012:249391.
7.	Nieder E.Sled prosthesis,rotating knee and hinge prosthesis:St.Georg model and ENDO-model.Differential therapy in primary knee joint arthroplasty.Orthopade,1991,20(3):170-180.
8.	Bistolfi A,Massazza G,Rosso F,et al.Rotating-hinge total knee for revision total knee arthroplasty.Orthopedics,2012,35(3):e325-330.
9.	Barrack RL.Evolution of the rotating hinge for complex total knee arthroplasty.Clin Orthop Relat Res,2001,(392):292-299.
10.	Pour AE,Parvizi J,Slenker N,et al.Rotating hinged total knee replacement:use with caution.J Bone Joint Surg (Am),2007,89(8):1735-1741.
11.	及松洁,李玉军,黄野,等.旋转铰链型膝关节假体临床应用30例随访观察.中国矫形外科杂志,2009,17(19):1455-1458.
12.	Bae DK,Song SJ,Yoon KH,et al.Long-term outcome of total knee arthroplasty in Charcot joint:a 10-to 22-year follow-up.J Arthroplasty,2009,24(8):1152-1156.
13.	Springer BD,Sim FH,Hanssen AD,et al.The modular segmental kinematic rotating hinge for nonneoplastic limb salvage.Clin Orthop Relat Res,2004,(421):181-187.
14.	Efe T,Roessler PP,Heyse TJ,et al.Mid-term results after implantation of rotating-hinge knee prostheses:primary versus revision.Orthop Rev (Pavia),2012,4(4):e35.
15.	Petrou G,Petrou H,Tilkeridis C,et al.Medium-term results with a primary cemented rotating-hinge total knee replacement.A 7-to 15-year follow-up.J Bone Joint Surg (Br),2004,86(6):813-817.
16.	Argenson JN,Aubaniac JM.Total knee arthroplasty in femorotibial instability.Orthopade,2000,29 Suppl 1:S45-47.
17.	Pacha-Vicente D,Malik A,Castellet-Feliu E,et al.Dislocation of rotating-hinge knee prostheses with antidislocation mechanism.J Arthroplasty,2008,23(2):299-303.
18.	Vince KG,Cameron HU,Hungerford DS,et al.What would you do? Case challenges in knee surgery.J Arthroplasty,2005,20(4 Suppl 2):44-50.
19.	Babazadeh S,Stoney JD,Lim K,et al.Arthroplasty of a Charcot knee.Orthop Rev (Pavia),2010,2(2):e17.

1. Yang JH,Yoon JR,Oh CH,et al.Primary total knee arthroplasty using rotating-hinge prosthesis in severely affected knees.Knee Surg Sports Traumatol Arthrosc,2012,20(3):517-523.
2. Hernández-Vaquero D,Sandoval-García MA.Hinged total knee arthroplasty in the presence of ligamentous deficiency.Clin Orthop Relat Res,2010,468(5):1248-1253.
3. Barrack RL,Lyons TR,Ingraham RQ,et al.The use of a modular rotating hinge component in salvage revision total knee arthroplasty.J Arthroplasty,2000,15(7):858-866.
4. 李宁秀,刘朝杰,李俊,等.四川省城乡居民SF-36评价参考值.华西医科大学学报,2001,32(1):43-47.
5. Friesenbichler J,Schwarzkopf R,Sadoghi P,et al.Failure rate of a rotating hinge knee design due to yoke fracture of the hinged tibial insert:a retrospective data analysis and review of the literature.Int Orthop,2012,36(5):993-998.
6. Lozano LM,López V,Ríos J,et al.Better outcomes in severe and morbid obese patients (BMI>35 kg/m²) in primary Endo-Model rotating-hinge total knee arthroplasty.Scientific World Journal,2012,2012:249391.
7. Nieder E.Sled prosthesis,rotating knee and hinge prosthesis:St.Georg model and ENDO-model.Differential therapy in primary knee joint arthroplasty.Orthopade,1991,20(3):170-180.
8. Bistolfi A,Massazza G,Rosso F,et al.Rotating-hinge total knee for revision total knee arthroplasty.Orthopedics,2012,35(3):e325-330.
9. Barrack RL.Evolution of the rotating hinge for complex total knee arthroplasty.Clin Orthop Relat Res,2001,(392):292-299.
10. Pour AE,Parvizi J,Slenker N,et al.Rotating hinged total knee replacement:use with caution.J Bone Joint Surg (Am),2007,89(8):1735-1741.
11. 及松洁,李玉军,黄野,等.旋转铰链型膝关节假体临床应用30例随访观察.中国矫形外科杂志,2009,17(19):1455-1458.
12. Bae DK,Song SJ,Yoon KH,et al.Long-term outcome of total knee arthroplasty in Charcot joint:a 10-to 22-year follow-up.J Arthroplasty,2009,24(8):1152-1156.
13. Springer BD,Sim FH,Hanssen AD,et al.The modular segmental kinematic rotating hinge for nonneoplastic limb salvage.Clin Orthop Relat Res,2004,(421):181-187.
14. Efe T,Roessler PP,Heyse TJ,et al.Mid-term results after implantation of rotating-hinge knee prostheses:primary versus revision.Orthop Rev (Pavia),2012,4(4):e35.
15. Petrou G,Petrou H,Tilkeridis C,et al.Medium-term results with a primary cemented rotating-hinge total knee replacement.A 7-to 15-year follow-up.J Bone Joint Surg (Br),2004,86(6):813-817.
16. Argenson JN,Aubaniac JM.Total knee arthroplasty in femorotibial instability.Orthopade,2000,29 Suppl 1:S45-47.
17. Pacha-Vicente D,Malik A,Castellet-Feliu E,et al.Dislocation of rotating-hinge knee prostheses with antidislocation mechanism.J Arthroplasty,2008,23(2):299-303.
18. Vince KG,Cameron HU,Hungerford DS,et al.What would you do? Case challenges in knee surgery.J Arthroplasty,2005,20(4 Suppl 2):44-50.
19. Babazadeh S,Stoney JD,Lim K,et al.Arthroplasty of a Charcot knee.Orthop Rev (Pavia),2010,2(2):e17.

Chinese Journal of Reparative and Reconstructive Surgery

MID-TERM EFFECTIVENESS OF ROTATING HINGE KNEE PROSTHESIS FOR SEVERE KNEE DEFORMITY

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