Rotating-hinge prosthesis for aseptic revision knee arthroplasty: A multicentre retrospective study of 127 cases with a mean follow-up of five years - 27/04/21
, Didier Mainard a, Brice Rubens-Duval b, Pierre-Emmanuel Papin c, Gilles Pasquier d, Matthieu Ehlinger ethe
French Society for Orthopaedic, Trauma Surgery (SoFCOT)f, 1
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Abstract |
Background |
The use of third-generation rotating-hinge knee prostheses has increased considerably in recent years. The more anatomical design of these prostheses, together with their controlled rotation system that reduces constraints generated by the single degree of liberty, have produced better outcomes. The objective of this study was to evaluate the clinical and radiological outcomes of revision knee arthroplasty for aseptic failure using rotating-hinge prostheses.
Hypothesis |
The rotating-hinge knee prostheses currently used in France provide significant improvements in function and self-sufficiency of patients undergoing revision knee arthroplasty, with outcomes comparable to those reported with constrained condylar knees.
Material and methods |
A multicentre retrospective study was conducted in 17 centres, under the auspices of the SoFCOT. The cohort consisted of 127 patients (127 knees) operated on before 2013. The main reasons for knee revision were aseptic loosening, major instability, mechanical failure, and extensor apparatus failure. Function and self-sufficiency were assessed using the International Knee Society (IKS) score and the Devane score, respectively. Survival was defined with all-cause surgical revision as the end point.
Results |
Mean follow-up was 67.3±11.8 months (range, 13–180 months). Significant improvements (p<0.001) were seen in the total IKS score (+42 points), the IKS function score (+12 points), and the knee IKS score (+30 points). Paradoxically, the Devane score decreased by 0.44 point. The 5-year survival rate was 77% (95% confidence interval, 0.70–0.85). Postoperative complications developed in 29% of patients (infection, n=12; aseptic loosening, n=11; and fracture, n=7).
Discussion |
Rotating-hinge prostheses provide satisfactory outcomes of knee arthroplasty revision and remain an effective option for complex cases, confirming our working hypothesis. Self-sufficiency diminishes slightly. The long-term outcomes obtained using rotating-hinge prostheses are, however, less satisfactory than those observed with constrained condylar knees for aseptic TKA revision, and the complication rate is higher, although the population and local circumstances are different. Discernment is therefore in order when determining the indications of rotating-hinge prostheses.
Level of evidence |
IV; retrospective cohort study.
Le texte complet de cet article est disponible en PDF.Keywords : Knee arthroplasty, Revision surgery, Hinged prosthesis, Rotating-hinge prosthesis, Survival, Complications
Plan
Vol 107 - N° 3
Article 102855- mai 2021 Retour au numéro
Article précédent
- A retrospective comparison of central and posterior hinge joints in 53 total knee arthroplasties
- Arthur Justo, Hugo Vilette, Matthieu Ehlinger, Gilles Pasquier, Pierre Laumonerie, Étienne Cavaignac
- Complications and failures of non-tumoral hinged total knee arthroplasty in primary and aseptic revision surgery: A review of 290 cases
- Étienne Caron, Antoine Gabrion, Matthieu Ehlinger, Nicolas Verdier, Brice Rubens-Duval, Thomas Neri, Pierre Martz, Sophie Putman, Gilles Pasquier, the French society of orthopedic surgery and traumatology (SOFCOT)
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