Abstract
Rotating hinged knee implants are highly constrained prostheses used in cases in which adequate stability is mandatory. Due to their constraint nature, multidirectional stresses are directed through the bone-cement-implant interface, which might affect fixation and survival. The goal of this study was to assess micromotion of a fully cemented rotating hinged implant using radiostereometric analysis (RSA). 20 patients requiring a fully cemented rotating hinge-type implant were included. RSA images were taken at baseline, 6 weeks, and 3, 6, 12, and 24 months postoperatively. Micromotion of femoral and tibial components referenced to markers in the bone was assessed with model-based RSA software, using implant CAD models. Total translation (TT), total rotation (TR), and maximal total point motion (MTPM) were calculated (median and range). At 2 years, TTfemurwas 0.38 mm (0.15-1.5), TRfemurwas 0.71° (0.37-2.2), TTtibiawas 0.40 mm (0.08-0.66), TRtibiawas 0.53° (0.30-2.4), MTPMfemurwas 0.87 mm (0.54-2.8), and MTPMtibiawas 0.66 mm (0.29-1.6). Femoral components showed more outliers (> 1 mm, > 1°) compared with tibial components. Fixation of this fully cemented rotating hinge-type revision implant seems adequate in the first 2 years after surgery. Femoral components showed more outliers, in contrast to previous RSA studies on condylar revision total knee implants.
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