Constrained Rotating Hinge Prostheses in Severe Haemophilic Knee Osteoarthritis

2018 ◽  
Vol 55 (4) ◽  
pp. 708-711
Author(s):  
Vlad Veringa ◽  
Wilhelm Friedl ◽  
Norin Forna ◽  
Andrei Ivan ◽  
Nina Filip ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Life Quality ◽  
Functional Results ◽  
Knee Prostheses ◽  
Haemophilic Arthropathy ◽  
Severe Bone Loss ◽  
Bone Damage ◽  
Rotating Hinge ◽  
Wound Healing Problems ◽  
Total Knee

The purpose of this experimental study is to present the design and biomechanical characteristics of cemented total knee prostheses type rotating-hinge RT-PLUS® (Smith and Nephew), as well as to evaluate their use in severe haemophilic knee arthropathy with major bone damage, ligamentous lesions, axial deviations and muscle retractions. We retrospectively evaluated 5 patients with severe haemophilic arthropathy with an average age of 48.5years. The functional results are good, with a significant improvement of range of motion (ROM) and pain relief resulting in a much better life quality. We did not have any stem loosening or any other complications except 2 wound healing problems which were treated successfully. The authors recommend this type of arthroplasty in severe haemophilic knee arthropathy or in any primary knee osteoarthritis with severe bone loss or any kind of ligamentous lesions.

scholarly journals A case of an atraumatic implant failure after primary rotating-hinge total knee arthroplasty

2021 ◽  
Vol 87 (3) ◽  
pp. 449-451
Author(s):  
Lucas Petitqueux ◽  
Karen Verhulst ◽  
Jan Dauwe ◽  
Dirk Dauwe
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Medical Literature ◽  
Femoral Stem ◽  
Revision Total Knee Arthroplasty ◽  
Knee Prostheses ◽  
Rotating Hinge ◽  
Total Knee ◽  
Rotating Hinge Knee ◽  
Implant Breakage

Rotating-hinge knee implants are fully constrained knee prostheses commonly used for revision total knee arthroplasty. Nevertheless, rotating-hinge devices have been increasingly utilized in primary setting. Complications are inevitable in orthopedic surgery, however, implant breakage after RHK arthroplasty has been rarely described in medical literature. We present a rare case of 70-year-old Caucasian, male patient who suffered an atraumatic femoral stem breakage in a primary NexGen ® Rotating Hinge Knee (Zimmer-Biomet ® , Warsaw, IN, USA).

scholarly journals Mid-term results after implantation of rotating-hinge knee prostheses: primary versus revision

2012 ◽  
Vol 4 (4) ◽  
pp. 35 ◽  
Author(s):  
Turgay Efe ◽  
Philip P. Roessler ◽  
Thomas J. Heyse ◽  
Carsten Hauk ◽  
Caroline Pahrmann ◽  
...  
Keyword(s):  
Knee Prosthesis ◽  
Survival Rates ◽  
Functional Results ◽  
Clinical Results ◽  
Knee Prostheses ◽  
Kaplan Meier ◽  
Rotating Hinge ◽  
Rotating Hinge Knee ◽  
Primary Implantation

The aim of the study was to evaluate the mid-term clinical results and survivorship of a rotating-hinge knee prosthesis (LINK® Endo-Model) in difficult primary and complex revision situations. Results after primary implantation were compared with those of revision procedures. Forty-nine prostheses in 45 patients were reviewed clinically during follow up. Twenty-one of these were implanted in primary and 28 in revision situations. Outcome was evaluated using commonly used scores (Knee Society, UCLA Activity, Lequesne) and a visual analog scale after a mean follow up of 56±37 months for 49 prostheses. Implant survival was analyzed using the Kaplan-Meier method. There were no significant differences in clinical examination and evaluation scores between the two groups (P>0.05). Survival rates at final follow up were 95% after primary implantation and 76% in revision procedures. The risk of prosthesis loss (odds ratio 5.7) was significantly higher after revision procedures (P=0.004). These data suggest that rotating-hinge knee prostheses provided good clinical and functional results in selected cases of advanced primary gonarthrosis associated with severe bone loss, ligamentous instability or comminuted fractures. They also provide good results in revision situations. However, the failure rate was significantly higher in cases of revision surgery.

The Management of Extensive Bone Loss in Primary and Revision Total Knee Replacement

2012 ◽  
Vol 12 (1) ◽  
pp. 32-35
Author(s):  
Silvestris Zebolds ◽  
Valdis Goncars ◽  
Ints Zommers ◽  
Konstantins Kalnberzs
Keyword(s):  
Bone Loss ◽  
Total Knee Replacement ◽  
Knee Society Score ◽  
Oxford Knee Score ◽  
Functional Results ◽  
Knee Score ◽  
Patients Satisfaction ◽  
Satisfaction Rate ◽  
Rotating Hinge ◽  
Total Knee

SummaryIntroduction.Total knee replacement (TKR) is still a challenging procedure for severe gonarthrosis patients. Deformities of knee joint (varus, valgus - more than 30 degrees), insufficiency of collateral ligaments and extensive bone loss could be a difficult problem to solve with standard knee endoprosthesis. Also in cases of revision - TKR the restoration of bone loss and regaining of stability of the joint could be a problem.Aim of the Study.The aim of our study was to analyse the results with Rotating - Hinge prosthesis after severe primary and revision TKR.Materials and Methods.34 patients (27 female, 7 male) were treated with Rotating - Hinge prosthesis during 12 years (first in 1997). Mean age of patients were 69 years. 17 operations were primary total knee arthroplasties and also 17 were revisions of the knee prosthesis. The Oxford Knee score was used for evaluation of patients satisfaction rate. The Knee Society Score was used to get objective functional results. For radiological analysis X-rays of knee joint in two projections were performed.Results.34 Oxford Knee score questionnaires were sent to patients, response we got from 27 patients (79%). Mean result from Oxford Knee score was 32 which is good. The same number of patients (34) were invited for examination using Knee Society score. The response were from 20 patients (59%). Mean result from Knee Society score was 83, which means excellent.Conclusions.Rotating-Hinge prosthesis allows to achieve good and excellent functional results and high patients satisfaction rate after severe primary and revision TKR. The biological age, general health condition, insufficiency of ligaments and previous infection in patients history have to be considered for choosing the tactics for each case.

scholarly journals Serum Metal Ion Concentrations in Paediatric Patients following Total Knee Arthroplasty Using Megaprostheses

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Jörg Friesenbichler ◽  
Patrick Sadoghi ◽  
Werner Maurer-Ertl ◽  
Joanna Szkandera ◽  
Mathias Glehr ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Metal Ion ◽  
Reference Laboratory ◽  
Knee Prostheses ◽  
Cobalt Chromium ◽  
Metal Debris ◽  
Paediatric Patients ◽  
Rotating Hinge ◽  
Total Knee

The purpose of this study was to determine the concentrations of cobalt, chromium, and molybdenum in the serum of paediatric tumour patients after fixed hinge total knee arthroplasty. Further, these metal ion levels were compared with serum metal ion levels of patients with other orthopaedic devices such as hip and knee prostheses with metal-on-metal or metal-on-polyethylene articulation to find differences between anatomical locations, abrasion characteristics, and bearing surfaces. After an average follow-up of 108 months (range: 67 to 163) of 11 paediatric patients with fixed hinge total knee arthroplasty, the mean concentrations for Co and Cr were significantly increased while Mo was within the limits compared to the upper values from the reference laboratory. Furthermore, these serum concentrations were significantly higher compared to patients with a standard rotating hinge device (P=0.002andP<0.001) and preoperative controls(P<0.001). On the other hand, the serum levels of patients following MoM THA or rotating hinge arthroplasty using megaprostheses were higher. Therefore, periodic long-term follow-ups are recommended due to the rising concerns about systemic metal ion exposure in the literature. Upon the occurrence of adverse reactions to metal debris the revision of the fixed hinge implant should be considered.

scholarly journals Comparison of the Clinical Results of Identically Designed Total Knee Prostheses with Different Surface Roughnesses

Coatings ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 486
Author(s):  
Sang Hyun Ko ◽  
Kyoung Ho Moon
Keyword(s):  
Surface Roughness ◽  
Knee Prosthesis ◽  
Functional Results ◽  
Clinical Results ◽  
Knee Prostheses ◽  
Total Knee Prosthesis ◽  
Significant Evidence ◽  
Average Surface ◽  
Total Knee ◽  
The Difference

The purpose of this study was to investigate the effects of the undersurface roughness of total knee prosthesis on clinical outcomes. We compared the clinical and radiological outcomes and prosthesis survivals in patients who underwent total knee arthroplasty using prosthesis with identical designs but different surface roughness (average surface roughnesses (Ra), 5.0 μm vs. 11.6 μm). The results showed that the knee prostheses with a more roughened undersurface (Ra = 11.6 μm) produced significantly better functional results and enhanced prosthesis survival. The difference in surface roughness was associated with incidence of osteolysis and loosening at the tibial baseplate, but not at the femoral component. Overall, our results provided significant evidence that the use of roughened undersurface of tibial baseplate would be a way to prevent aseptic loosening.

scholarly journals Stacked Tantalum Cones as a Method for Treating Severe Distal Femoral Bone Deficiency in Total Knee Arthroplasty

2018 ◽  
Vol 32 (09) ◽  
pp. 833-840 ◽  
Author(s):  
Ashok Rajgopal ◽  
Inayat Panda ◽  
Sidharth Yadav ◽  
Om Wakde
Keyword(s):  
Bone Loss ◽  
Knee Prosthesis ◽  
Femoral Bone ◽  
Trabecular Metal ◽  
Septic Loosening ◽  
Superficial Infection ◽  
Bone Deficiency ◽  
Severe Bone Loss ◽  
Rotating Hinge ◽  
Total Knee

AbstractSevere bone loss in distal femur has traditionally been managed with bulk cementing, bone graft, metal augments, trabecular metal cones, and mega prosthesis. The authors present an alternative method using a stacked configuration of two tantalum cones to manage severe distal femoral bone loss. This study aims to evaluate the mid-term outcomes and possible complications in patients treated with this novel technique. We retrospectively analyzed the prospectively maintained records of 16 knees (in 16 patients) presenting with severe distal femoral bone deficiency due to septic loosening (5), giant cell tumor (GCT; 4), periprosthetic fracture (3), aseptic loosening (3), and distal femoral comminuted fracture with severe osteoarthritis (1). A standard medial parapatellar approach was taken in all our cases followed by preparation of distal femoral bone defect and use of two bridging tantalum trabecular metal cones to fill the defect, followed by implantation of rotating hinge knee prosthesis. At an average follow-up of 57 months (4.75 years), the average Knee Society Score was 74.56 (64–87) and the mean range of motion was 97.8 (70–120) degrees. Radiologically, all 16 knees showed good osteointegration with no evidence of progressive radiolucency or loosening. Complications included two patients with superficial infection (healed with antibiotics), and one with recurrence of GCT requiring tumor megaprosthesis reconstruction. The authors concluded that the stacked configuration of cones provides additional coverage and stability with good osteointegration and found it to be particularly useful in distal femoral GCTs and fracture situations. They recommend the use of stacked cones in selected cases of severe distal femoral deficiency.

DISLOCATION OF ROTATING HINGE TOTAL KNEE PROSTHESES

2003 ◽  
Vol 85 (3) ◽  
pp. 448-453 ◽  
Author(s):  
WILLIAM G. WARD ◽  
DAVID HAIGHT ◽  
PAUL RITCHIE ◽  
STAN GORDON ◽  
JEFFREY J. ECKARDT
Keyword(s):  
Knee Prostheses ◽  
Rotating Hinge ◽  
Total Knee

scholarly journals Midterm Results of a New Rotating Hinge Knee Implant: A 5-Year Follow-Up

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Christoph Böhler ◽  
Paul Kolbitsch ◽  
Reinhard Schuh ◽  
Richard Lass ◽  
Bernd Kubista ◽  
...  
Keyword(s):  
Oxford Knee Score ◽  
Functional Results ◽  
Midterm Results ◽  
Tissue Quality ◽  
Joint Infections ◽  
Rotating Hinge ◽  
Total Knee ◽  
Rotating Hinge Knee ◽  
Primary Implantation

Background. In the current study, we investigated midterm results of a new rotating hinge total knee arthroplasty (EnduRo prosthesis), which uses a new bearing material (CFR PEEK). Methods. We prospectively analysed data of 50 patients with a minimum follow-up of 5 years. In 24 (48%) patients, a primary implantation was performed and 26 (52%) were revision cases. Clinical and radiographic examinations were performed preoperatively as well as postoperatively after 3 and 12 months and annually thereafter. The Knee Society Score (KSS), WOMAC, Oxford Knee Score (OKS), and range of motion (ROM) were used for clinical assessment. Results. KSS, WOMAC, OKS, and ROM significantly improved between the preoperative and the follow-up investigations. The overall survival rate with revision for any reason as an endpoint was 77.9% after five years. The number of complications was significantly higher in the revision group (p=0.003). Conclusion. The EnduRo prosthesis provides highly satisfying clinical and functional results in severe primary as well as in revision cases. Implant-associated complications were rare. However, in cases of revision surgery, the risk for complications was considerably high, mostly related to previous joint infections and poor soft tissue quality.

scholarly journals Difference in patient-reported outcomes of various patellar component designs in total knee arthroplasty: A randomized clinical study

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902199606
Author(s):  
Takeshi Mochizuki ◽  
Koichiro Yano ◽  
Katsunori Ikari ◽  
Ken Okazaki
Keyword(s):  
Knee Osteoarthritis ◽  
Clinical Effects ◽  
Patellar Component ◽  
American College Of Rheumatology ◽  
Randomized Clinical Study ◽  
Component Design ◽  
Patient Reported ◽  
Total Knee ◽  
The Difference ◽  
And Function

Purpose: This study investigated the clinical effects of different patellar components without being affected by the femoral component design in total knee arthritis (TKA) for patients with knee osteoarthritis (OA). Methods: In total, 48 patients with OA who met the criteria of the American College of Rheumatology for OA were enrolled and randomly assigned in a 1:1 ratio to two groups according to the usage of patellar component design for TKA (medialized dome type [dome group] or medialized anatomic type [anatomic group]). To evaluate the clinical outcomes for TKA, knee range of motion (ROM), pain intensity of 0–100 mm visual analog scale (pain VAS), and the Japanese Knee Osteoarthritis Measure (JKOM) score were obtained at baseline and year 1. Results: The difference in knee ROM, pain VAS, or total JKOM score at year 1 was not significant between the dome and anatomic groups ( p = 0.398, 0.733 and 0.536, respectively). Moreover, similar results were obtained for changes in knee ROM, pain VAS, or total JKOM scores from baseline. In both groups, the pain VAS and total JKOM scores were significantly improved at year 1. Conclusion: Both dome and anatomic groups in TKA are significantly effective for pain and function using the JKOM score. However, their efficacy did not differ, according to the JKOM score. Results of this study are rare information focusing on the patellar component design and provide one of the insights into the TKA clinical management.

scholarly journals Circulating IL-10 is compromised in patients predisposed to developing and in patients with severe knee osteoarthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tyler Barker ◽  
Victoria E. Rogers ◽  
Vanessa T. Henriksen ◽  
Roy H. Trawick ◽  
Nathan G. Momberger ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Cruciate Ligament ◽  
Ligamentous Injury ◽  
Radiographic Evidence ◽  
X Ray ◽  
Tnf Α ◽  
Total Knee ◽  
Anterior Cruciate ◽  
Anterior Cruciate Ligament Surgery ◽  
Necrosis Factor

AbstractThe purpose of this investigation was to identify if serum interleukin (IL)-10 and tumor necrosis factor (TNF)-α concentrations and their ratio (IL-10/TNF-α) are altered in subjects predisposed to developing knee osteoarthritis following ligamentous injury and in those with severe knee osteoarthritis. Serum IL-10 and TNF-α concentrations were measured in four groups of subjects (n = 218): (1) reportedly-healthy and non-injured control subjects (CON; n = 92), (2) subjects scheduled to undergo anterior cruciate ligament surgery (ACL; n = 42), (3) non-surgical subjects with knee osteoarthritis (OA; n = 60), and (4) subjects with knee osteoarthritis scheduled to undergo total knee arthroplasty (TKA; n = 24). X-ray images were used to grade the severity of knee osteoarthritis. Serum IL-10 and the serum IL-10/TNF-α ratio were significantly lower while serum TNF-α was not significantly perturbed with severe compared to moderate knee osteoarthritis (i.e., Kellgren-Lawrence grade 4 vs. 3, respectively). Serum IL-10 was significantly lower in the absence of serum TNF-α alterations in the ACL group. We conclude that serum IL-10 concentrations are compromised in subjects predisposed to developing knee osteoarthritis following ligamentous trauma and in subjects with radiographic evidence of severe knee osteoarthritis.

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