Abstract
Background Rotating hinge knee prostheses are typically used in revision and severe primary total knee arthroplasty (TKA). For these challenging patient groups, currently only few studies with mid- or even long-term follow-up and adequate patient numbers are available. In addition, a more specific definition is needed of the indications for a rotating hinge prothesis in primary patients beyond the use in bone defects. Methods In this prospective study, 170 primary and 62 revision TKA patients were included who received a rotating hinge knee prosthesis at the study centre between the years 2009 and 2014. Of these, 98 primary and 22 revision TKA patients were available for 5-year functional and clinical follow-up examinations. Prosthesis survival in both patient groups could be compared up to a 9-year follow-up. Results Postoperatively, functional results including range of motion (ROM) and clinical scores like the Oxford Knee Score (OKS) and subscales of the Knee Society Score (KSS) improved better in patients treated for primary knee arthroplasty than for revision patients. Besides the patient group (primary vs. revision TKA), no overall influencing factors (age, body mass index, gender, etc.) regarding functional results could be identified in a multiple linear regression analysis. The revision rate of primary patients was significantly lower than in the revision patients, with an 8-year Kaplan-Meier prosthesis survival of 88% in the Primary and 60% in the Revision group. Conclusion The prosthesis provides promising results in severe primary and revision knee arthroplasty. In addition to commonly agreed recommendations regarding the use of rotating hinge knee prostheses for primary surgery, six specific indications are proposed and discussed here as a base for scientific debate.
Highlights
Total knee arthroplasty (TKA) is a frequently performed surgery with an increasing number of interventions [1, 2]
Eligibility criteria were limited to patients in the clinic of the principal investigator treated with the EnduRo rotating hinge prosthesis for primary or revision total knee arthroplasty (TKA) for all indications except bone tumours
Of the 170 primary and 62 revision TKA patients which were prospectively included in the study, 98 primary and 22 revision TKA patients were still available for the 5-year follow-up examinations
Summary
Total knee arthroplasty (TKA) is a frequently performed surgery with an increasing number of interventions [1, 2]. Rotating hinge knee prostheses are typically used in revision and severe primary total knee arthroplasty (TKA). For these challenging patient groups, currently only few studies with mid- or even long-term follow-up and adequate patient numbers are available. In this prospective study, 170 primary and 62 revision TKA patients were included who received a rotating hinge knee prosthesis at the study centre between the years 2009 and 2014. 98 primary and 22 revision TKA patients were available for 5-year functional and clinical follow-up examinations Prosthesis survival in both patient groups could be compared up to a 9-year follow-up. In addition to commonly agreed recommendations regarding the use of rotating hinge knee prostheses for primary surgery, six specific indications are proposed and discussed here as a base for scientific debate
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