International Orthopaedics

, Volume 36, Issue 5, pp 993–998 | Cite as

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

  • Joerg Friesenbichler
  • Ran Schwarzkopf
  • Patrick Sadoghi
  • Scott E. Marwin
  • Mathias GlehrEmail author
  • Werner Maurer-Ertl
  • Andreas Leithner
Original Paper



Rotating hinge knee prostheses are known to provide inherent stability. Yoke fractures of the hinged tibial insert of modern generation rotating hinge devices are a matter of continued concern. The aim of this study was to describe incidence and management of yoke fracture of the LPS™ hinged tibial insert.


Retrospective data analysis of two institutions identified 40 patients with a LPS™ total knee arthroplasty. Implant survival and prosthetic complications was calculated according to Kaplan-Meier.


Out of the group of 40 patients, four fractures of the metal yoke occurred in four cases (failure rate: 10%). Furthermore, a second fracture occurred in two patients. The overall revision-free prosthetic survival was 57% at 38 months, while prosthetic survival until yoke fracture was 86% at 38 months.


Handling yoke fractures as mechanical complication includes replacing the hinged insert, stabilization of the joint and joint line height preservation in order to decrease the cantilever effect at the insert-base plate interface.


Total Knee Arthroplasty Joint Line Mechanical Complication Revision Total Knee Arthroplasty Tibial Insert 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Joerg Friesenbichler
    • 1
  • Ran Schwarzkopf
    • 2
  • Patrick Sadoghi
    • 1
  • Scott E. Marwin
    • 2
  • Mathias Glehr
    • 1
    Email author
  • Werner Maurer-Ertl
    • 1
  • Andreas Leithner
    • 1
  1. 1.Department of Orthopaedic SurgeryMedical University of GrazGrazAustria
  2. 2.Department of Orthopaedic SurgeryNYU Hospital of Joint DiseaseNew YorkUSA

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